Provider Demographics
NPI:1770803462
Name:SERVE THE PEOPLE, INC
Entity type:Organization
Organization Name:SERVE THE PEOPLE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:BECERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-352-2911
Mailing Address - Street 1:1206 E 17TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-2641
Mailing Address - Country:US
Mailing Address - Phone:714-352-2911
Mailing Address - Fax:714-352-2903
Practice Address - Street 1:1206 E 17TH STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-2641
Practice Address - Country:US
Practice Address - Phone:714-352-2911
Practice Address - Fax:714-352-2903
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SERVE THE PEOPLE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-04
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001441207Q00000X, 261Q00000X, 261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFB219AMedicare UPIN
CA751063Medicare Oscar/Certification