CENTRAL CITY COMMUNITY HEALTH CENTER, INC. (NPI# 1508254814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508254814 |
| Entity Type | Organization |
| Organization Name | CENTRAL CITY COMMUNITY HEALTH CENTER, INC. |
| Practice Address |
81709 Dr Carreon Blvd Ste E1 Indio CA 92201-5589 |
| Mailing Address |
1000 San Gabriel Blvd Ste 200 Rosemead CA 91770-4394 |
| Practice Telephone | 7603423336 |
| Practice Fax Number | 8669979757 |
| Mailing Telephone | 3237240019 |
| Mailing Fax Number | 3232487044 |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2020-04-27 |
| Authorized Official Name | MARICELA MENDOZA (MANAGED CARE LEAD) |
| Authorized Official Telephone | 3237240019 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1033488416 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 81709 Dr Carreon Blvd Ste E2, Indio, CA 922015589 | 7603423336 | |
| 81709 Dr Carreon Blvd Ste D1, Indio, CA 92201 | 7603433336 | 8669979757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174996318 | Central City Community Health Center, Inc. | Clinic/Center | 268 Mcarthur Way Ste A, Upland, CA 91786-5615 | 2015-11-10 |
| 1972912236 | Central City Community Health Center, Inc. | Clinic/Center | 10050 Garvey Ave Ste 111, El Monte, CA 91733 | 2014-08-11 |
| 1558770818 | Central City Community Health Center, Inc. | General Practice | 4160 Maine Ave Ste B1b2b3, Baldwin Park, CA 91706-3304 | 2014-08-11 |
| 1285788059 | Central City Community Health Center, Inc. | General Practice | 2237 W Ball Rd, Anaheim, CA 92804 | 2007-01-22 |
| 1144842014 | Central City Community Health Center, Inc. | Clinic/Center | 1814 W Lincoln Ave, Anaheim, CA 92801-6730 | 2020-05-13 |
| 1598386559 | Central City Community Health Center, Inc. | Clinic/Center | 1820 W Lincoln Ave, Anaheim, CA 92801-6730 | 2020-04-30 |
| 1194265637 | Central City Community Health Center, Inc. | Clinic/Center | 5715 S Broadway, Los Angeles, CA 90037 | 2017-03-02 |
| 1972040467 | Central City Community Health Center, Inc. | Clinic/Center | 268 Mcarthur Way, Upland, CA 91786-5615 | 2017-01-23 |
| 1407230899 | Central City Community Health Center, Inc. | Clinic/Center | 2243 W Ball Rd, Anaheim, CA 92804 | 2015-07-15 |
| 1669881926 | Central City Community Health Center, Inc. | Clinic/Center | 4126 Maine Ave, Baldwin Park, CA 91706-3306 | 2014-08-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CENTRAL CITY COMMUNITY HEALTH CENTER, INC. | 1000 San Gabriel Blvd, Ste 200, Rosemead, CA 91770-4394 |
| Street Address |
81709 DR CARREON BLVD STE E1 |
| City | INDIO |
| State | CA |
| Zip Code | 92201-5589 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275068801 | Min Cen | Nurse Practitioner | 81709 Dr Carreon Blvd Ste E1, Indio, CA 92201 | 2017-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174151534 | Kayla Marie Berry | Licensed Vocational Nurse | Telecare Riverside County Psychiatric Health Facility, Indio, CA 92201 | 2020-03-31 |
| 1699327353 | Nawar Hadid | Dentist | 81735 Ca-111, Indio, CA 92201 | 2019-07-12 |
| 1427521889 | Thanh Trang Thi Nguyen Md Inc | Internal Medicine | 44100 Jefferson St., #e507, Indio, CA 92201 | 2019-01-09 |
| 1306328315 | Grant Nishimura | Dentist | 81-637, Suite 1, Ca-111, Indio, CA 92201 | 2018-09-06 |
| 1700363645 | Desert Physical Medicine | General Practice | 81765 Highway 111, Ste #3, Indio, CA 92201 | 2018-07-24 |
| 1336668151 | U & I Care Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 44105 Jackson St Ste 204, Indio, CA 92201 | 2017-09-13 |
| 1154847234 | Myung Kee Park | Dentist | 81106 Ca-111, #c, Indio, CA 92201 | 2017-08-21 |
| 1912434937 | Mirage Home Health | Home Health | 82691 Miles Ave, Indio, CA 92201 | 2017-05-22 |
| 1497294821 | Orthopedic and Physical Medicine Associates Inc | Chiropractor | 81765 Hwy 111, #3, Indio, CA 92201 | 2017-02-17 |
| 1497103758 | Timothy Smith | Contractor | 81337 Avenida Romero, Indio, CA 92201 | 2016-05-27 |
| Find all providers in zip 92201 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770910796 | Urban Community Action Projects | Clinic/Center | 44359 Palm Street, Indio, CA 92201-3116 | 2013-10-04 |
| 1154758654 | Urban Community Action Projects | Clinic/Center | 47470 Van Buren St, Indio, CA 92201-7139 | 2013-09-30 |
| 1437795838 | Borrego Community Health Foundation | Clinic/Center | 83791 Date Ave, Indio, CA 92201-4737 | 2019-11-20 |
| 1992245252 | Central City Community Health Center | Clinic/Center | 81709 Dr Carreon Blvd Ste D1, Indio, CA 92201-5578 | 2017-03-06 |
| 1093138430 | Clinicas De Salud Del Pueblo, Inc | Clinic/Center | 83791 Date Ave, Indio, CA 92201-4737 | 2014-01-21 |
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| 1083221451 | Harmony Health Medical Clinic and Family Resource Center | Clinic/Center | 1930 N. Beale Road, Marysville, CA 95901-6915 | 2020-09-29 |
| 1235745928 | Community Medical Centers Inc | Clinic/Center | 747 E Channel St, Stockton, CA 95202-2628 | 2020-09-18 |
| 1760098503 | Chicago Clinica Medica Familiar Operated By Neighborhood Healthcare | Clinic/Center | 4022 Chicago Ave Ste A, Riverside, CA 92507-5340 | 2020-09-17 |
| 1164037149 | Camarena Health | Clinic/Center | 16645 Road 26, Madera, CA 93638-0830 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
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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.