QUEENSCARE FAMILY CLINICS (NPI# 1215293733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215293733 |
| Entity Type | Organization |
| Organization Name | QUEENSCARE FAMILY CLINICS |
| Practice Address |
4618 Fountain Ave Los Angeles CA 90029-1977 |
| Mailing Address |
1300 N Vermont Ave # 1002 Los Angeles CA 90027-6005 |
| Practice Telephone | 3236694305 |
| Practice Fax Number | 3239532757 |
| Mailing Telephone | 3236694305 |
| Mailing Fax Number | 3239532757 |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2012-04-10 |
| Authorized Official Name | BARBARA B HINES (PRESIDENT/CEO) |
| Authorized Official Telephone | 3236694305 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
550001649 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053677401 | Queenscare Family Clinics | Dentist | 4618 Fountain Ave, Los Angeles, CA 90029-1977 | 2012-04-10 |
| 1043476609 | Queenscare Family Clinics | Clinic/Center | 1300 N Vermont Ave, Suite 809, Los Angeles, CA 90027-6005 | 2008-08-04 |
| 1043381213 | Queenscare Family Clinics | Clinic/Center | 3242 W 8th St, Los Angeles, CA 90005-2176 | 2006-11-10 |
| Street Address |
4618 FOUNTAIN AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90029-1977 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134198922 | Judy Jooyun Lee | Pediatrics | 4618 Fountain Ave, Los Angeles, CA 90029-1977 | 2006-03-15 |
| 1437701208 | David Angel Cortez | Nurse Practitioner | 4618 Fountain Ave, Los Angeles, CA 90029-1977 | 2019-07-11 |
| 1235697251 | Top Triamwong | Pharmacist | 4618 Fountain Ave, Los Angeles, CA 90029-1977 | 2019-03-08 |
| 1962976456 | Faith Amarachukwu Onwuka | Nurse Practitioner | 4618 Fountain Ave, Los Angeles, CA 90029-1977 | 2019-01-17 |
| 1043729825 | Erinn Lewis Carusetta | Nurse Practitioner | 4618 Fountain Ave, Los Angeles, CA 90029-1977 | 2017-09-25 |
| 1831628197 | Mehranz Hakimi | Pharmacist | 4618 Fountain Ave, Los Angeles, CA 90029-1977 | 2017-06-08 |
| 1407383532 | Kristie Nakatsuchi | Pharmacist | 4618 Fountain Ave, Los Angeles, CA 90029-1977 | 2017-05-19 |
| 1376083063 | Korina D Milian | Community Health Worker | 4618 Fountain Ave, Los Angeles, CA 90029-1977 | 2017-03-01 |
| 1619417359 | Sandra Marisol Guzman | Community Health Worker | 4618 Fountain Ave, Los Angeles, CA 90029-1977 | 2017-02-28 |
| 1174071799 | Yen Le | Nurse Practitioner | 4618 Fountain Ave, Los Angeles, CA 90029-1977 | 2016-09-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053884775 | Melrose Recovery, LLC. | Substance Abuse Rehabilitation Facility | 1253 N Commonwealth Ave, Los Angeles, CA 90029 | 2019-01-04 |
| 1548740939 | Mission City Community Network Inc | Clinic/Center | 5300 Santa Monica Blvd Ste 202, Los Angeles, CA 90029 | 2018-08-15 |
| 1215454707 | Dennis De Vera | Respiratory Therapist, Registered | 1154 N. Berendo St, Los Angeles, CA 90029 | 2017-08-24 |
| 1508390881 | Acadia Malibu, Inc. | Community/Behavioral Health | 4423 and 4423 1/2 Santa Monica Boulevard, Los Angeles, CA 90029 | 2017-04-13 |
| 1023556610 | Jasen Mcgoldrick | Substance Abuse Rehabilitation Facility | 4445 Burns Ave., Los Angeles, CA 90029 | 2017-02-03 |
| 1679930572 | Sukhwa Park | Acupuncturist | 4870 Santa Monica Blvd, Los Angeles, CA 90029 | 2016-01-22 |
| 1629326749 | Jocelyn Anne Brown | Midwife | 1042 Sanborn Ave Apt 9, Los Angeles, CA 90029 | 2012-08-21 |
| 1811211915 | Advanced Skilled Nursing Inc. | Skilled Nursing Facility | 975 North Virgil Avenue, Los Angeles, CA 90029 | 2010-03-17 |
| 1427244060 | Manuel Masaganda Ferreras | Technician/Technologist | 1131 N Vermont Ave Ste 101, Los Angeles, CA 90029 | 2007-09-18 |
| 1033321013 | Zhirayr Jerry Khoshoryan | Chiropractor | 1233 Vermont Ave., Suite 1b, Los Angeles, CA 90029 | 2007-05-04 |
| Find all providers in zip 90029 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790385227 | Johnson Ann Wong Dental Corporation | Dentist | 6512 N Figueroa St Ste 3, Los Angeles, CA 90042-2155 | 2020-10-26 |
| 1326535949 | Haejin Kang | Dentist | 3932 Wilshire Blvd Ste 200, Los Angeles, CA 90010-3307 | 2018-04-19 |
| 1609382860 | Dr Daniel Meir Klein Dds, Apc | Dentist | 5001 Wilshire Blvd Ste 209, Los Angeles, CA 90036-6104 | 2017-12-22 |
| 1154858082 | Jenny Garcia | Dentist | 1042 1/2 N Ardmore Ave, Los Angeles, CA 90029-2402 | 2017-05-23 |
| 1013365881 | Jessica Yoon Kyung Pack | Dentist | 1234 Wilshire Blvd Apt 212, Los Angeles, CA 90017-1974 | 2016-06-02 |
| 1588011225 | Chelsea Elese Zamudio | Dentist | 1125 S Wooster St, Los Angeles, CA 90035-1405 | 2016-05-23 |
| 1457707861 | Denisse Monroy | Dentist | 11900 Goshen Ave Apt 103, Los Angeles, CA 90049-6379 | 2016-05-04 |
| 1851784268 | Woo Ram Lee | Dentist | 1343 S Carmelina Ave, Apt 7, Los Angeles, CA 90025-1987 | 2015-03-09 |
| 1982010427 | Tiffany Wu | Dentist | 5262 E Beverly Blvd, Los Angeles, CA 90022-2002 | 2014-07-04 |
| 1447664578 | Jack Yeung | Dentist | 1222 Mcclellan Dr Apt 2, Los Angeles, CA 90025-1010 | 2014-06-17 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90029 |
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| 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.