QUEENSCARE HEALTH CENTERS (NPI# 1093886251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093886251 |
| Entity Type | Organization |
| Organization Name | QUEENSCARE HEALTH CENTERS |
| Other Organization Name | QUEENSCARE HEALTH CENTERS - BRESEE |
| Practice Address |
184 Bimini Pl Los Angeles CA 90004-5903 |
| Mailing Address |
950 S Grand Ave 2nd Floor South Los Angeles CA 90015-4202 |
| Practice Telephone | 2132016878 |
| Practice Fax Number | 2132016872 |
| Mailing Telephone | 3236694302 |
| Mailing Fax Number | 3239536244 |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2014-12-08 |
| Authorized Official Name | MRS. BARBARA B HINES (PRESIDENT & CEO) |
| Authorized Official Telephone | 3236694305 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
550000045 | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| QueensCare Health Centers - Bresee | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740835743 | Queenscare Health Centers | Clinic/Center | 303 Loma Dr, Los Angeles, CA 90017-1103 | 2019-08-06 |
| 1992106082 | Queenscare Health Centers | Pharmacy | 4816 E 3rd St, Los Angeles, CA 90022-1602 | 2014-09-09 |
| 1952716441 | Queenscare Health Centers | Pharmacy | 4618 Fountain Ave, Los Angeles, CA 90029-1977 | 2014-06-24 |
| 1104075282 | Queenscare Health Centers | Clinic/Center | 4816 E 3rd St, Los Angeles, CA 90022-1602 | 2008-09-15 |
| 1013083666 | Queenscare Health Centers | Clinic/Center | 150 N Reno St, Los Angeles, CA 90026-4656 | 2006-11-27 |
| 1639241888 | Queenscare Health Centers | Clinic/Center | 4618 Fountain Ave, Los Angeles, CA 90029-1830 | 2006-11-14 |
| 1801967062 | Queenscare Health Centers | Clinic/Center | 4448 York Blvd, Los Angeles, CA 90041-3328 | 2006-11-10 |
| 1164593331 | Queenscare Health Centers | Clinic/Center | 133 N Sunol Dr, Los Angeles, CA 90063-1429 | 2006-11-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | QUEENSCARE HEALTH CENTERS | 950 South Grand Ave Second Floor South, Los Angeles, CA 90015-4202 |
| Street Address |
184 BIMINI PL |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90004-5903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205879798 | Robert Sherman Vinetz | Pediatrics | 184 Bimini Pl, Los Angeles, CA 90004-5903 | 2006-06-13 |
| 1760844310 | Jedd Lyn Ticar | Pediatrics | 184 Bimini Pl, Los Angeles, CA 90004-5903 | 2016-03-23 |
| 1609255850 | Robert Hagbom | Pediatrics | 184 Bimini Pl, Los Angeles, CA 90004-5903 | 2015-05-20 |
| 1528088184 | Catherine Mccoy Hill | Nurse Practitioner | 184 Bimini Pl, Los Angeles, CA 90004-5903 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225504160 | Jessica M. Louie | Pharmacist | 590 North Vermont Avenue, Suite 334, Los Angeles, CA 90004 | 2018-10-18 |
| 1033615828 | Javier G Ibarra | Counselor | 3910 Oakwood Ave., Los Angeles, CA 90004 | 2018-04-02 |
| 1558804351 | Bhc Alhamba Hospital | Psychiatric Residential Treatment Facility | 115 N. Mccadden Place, Los Angeles, CA 90004 | 2016-11-28 |
| 1275907719 | Rozalin Banafsheian | Psychologist | 522 N. Larchmont, Los Angeles, CA 90004 | 2015-11-20 |
| 1104214196 | Estrellita Rubio Reyes | Pediatrics | 3908 Beverly Blvd., Los Angeles, CA 90004 | 2014-12-30 |
| 1760888226 | Hardy Ophuls | Marriage & Family Therapist | 439 N. Larchmont Bl., Los Angeles, CA 90004 | 2014-11-11 |
| 1528462991 | Latrice Nicole Hardison | Licensed Vocational Nurse | 225 N. Mariposa Ave, Los Angeles, CA 90004 | 2014-10-14 |
| 1215331947 | Shonn Bunn | Rehabilitation Practitioner | 433 N. Hoover, Los Angeles, CA 90004 | 2014-10-09 |
| 1609296581 | Michael Armen Kezian | Dentist | 581 N Larchmont Blvd, Los Angeles, CA 90004 | 2014-04-18 |
| 1427485549 | Kir Medical Group | Family Medicine | 123 177th Street, Los Angeles, CA 90004 | 2013-10-03 |
| Find all providers in zip 90004 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1649896903 | Jwch Institute, Inc. | Clinic/Center | 964 N Vermont Ave, Los Angeles, CA 90029-3529 | 2020-06-23 |
| 1306461074 | Jwch Institute, Inc | Clinic/Center | 855 N Vermont Ave, Los Angeles, CA 90029-3516 | 2020-06-09 |
| 1578186144 | Universal Community Health Center | Clinic/Center | 5460 E Beverly Blvd, Los Angeles, CA 90022-2208 | 2020-05-18 |
| 1114556263 | Arm 4 Arm Foundation | Clinic/Center | 231 W Vernon Ave., Suite 101, 201, Los Angeles, CA 90037 | 2020-04-01 |
| 1225673262 | Complete Care Community Health Center, Inc | Clinic/Center | 1300 N Vermont Ave Ste 606, Los Angeles, CA 90027-6088 | 2019-11-13 |
| 1811548712 | Jwch Institute, Inc | Clinic/Center | 1670 E 120 Street, West Support Bldg #14 Fl 2, Los Angeles, CA 90059-3026 | 2019-09-23 |
| 1902453731 | Altamed Health Services Corp | Clinic/Center | 2100 W 3rd St Ste 400, Los Angeles, CA 90057-2290 | 2019-08-26 |
| 1992269757 | Los Angeles Christian Health Centers | Clinic/Center | 325 7th Street, Los Angeles, CA 90014 | 2019-01-25 |
| 1083132849 | Altamed Health Services Corp | Clinic/Center | 2100 W 3rd St Ste 220, Los Angeles, CA 90057-1993 | 2017-08-31 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90004 |
Please comment or provide details below to improve the information on QUEENSCARE HEALTH CENTERS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.