CENTRAL CITY COMMUNITY HEALTH CENTER, INC. (NPI# 1588972129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588972129 |
| Entity Type | Organization |
| Organization Name | CENTRAL CITY COMMUNITY HEALTH CENTER, INC. |
| Practice Address |
12511 Brookhurst St Garden Grove CA 92840 |
| Mailing Address |
1000 San Gabriel Blvd Ste 200 Rosemead CA 91770-4394 |
| Practice Telephone | 7146437176 |
| Practice Fax Number | 7146437180 |
| Mailing Telephone | 3237240019 |
| Mailing Fax Number | 3232487044 |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2020-02-11 |
| 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 |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1235283094 | 05 |
| 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 |
| 1508254814 | Central City Community Health Center, Inc. | General Practice | 81709 Dr Carreon Blvd Ste E1, Indio, CA 92201-5589 | 2015-01-08 |
| 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 |
| 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 |
12511 BROOKHURST ST |
| City | GARDEN GROVE |
| State | CA |
| Zip Code | 92840 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720024441 | Gerald Colborne Weeks II | Chiropractor | 12511 Brookhurst St, Garden Grove, CA 92840-4806 | 2006-06-21 |
| 1144529926 | Erin Benesch | Psychiatry & Neurology | 12511 Brookhurst St, 2 Fl, Garden Grove, CA 92840-4806 | 2011-03-20 |
| 1902972938 | Tu Catherine Dao | Dentist | 12511 Brookhurst St, Garden Grove, CA 92840-4806 | 2006-11-28 |
| 1477625630 | Robert Lee Jones | Dentist | 12511 Brookhurst St, Garden Grove, CA 92840-4806 | 2006-11-14 |
| 1861428971 | Robert F Myers | Psychologist | 12511 Brookhurst St, Garden Grove, CA 92840-4806 | 2006-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588283808 | Kimberly Gaeta | Behavioral Analyst | 123935 Lewis Street, Ste 202, Garden Grove, CA 92840 | 2020-04-16 |
| 1396397170 | Rosa Cortez | Behavior Technician | 12443 Lewis Street, #201, Garden Grove, CA 92840 | 2019-07-12 |
| 1376005934 | Sekboppa Sor | Nurse Practitioner | An Lanh Free Clinic, 10861 Acacia Pkwy., Garden Grove, CA 92840 | 2019-04-03 |
| 1346730116 | Vinh Le Tran | Pharmacist | 12666 Brookhurst St. Suite 110, Garden Grove, CA 92840 | 2018-05-16 |
| 1841715232 | Scott R. Blair | Physician Assistant | 12828 Harbor Blvd Ste 200, Garden Grove, CA 92840 | 2017-08-07 |
| 1881049492 | Carmen Keally | Dietitian, Registered | 12602 9th St, Garden Grove, CA 92840 | 2016-05-02 |
| 1548688732 | House Call Medical Associates, Inc. | Internal Medicine | 12865 Main St Ste 105, Garden Grove, CA 92840 | 2014-04-03 |
| 1851733059 | Carly Ann Wade | Marriage & Family Therapist | 12755 Brookhurst St. Ste 116, Garden Grove, CA 92840 | 2013-07-29 |
| 1003159864 | Priyal Shah Ohri | Dentist | 10602 Chapman Ave, Suite 200, Garden Grove, CA 92840 | 2013-03-30 |
| 1770853244 | Joseph Pham | Pharmacist | 12001 Euclid St., Garden Grove, CA 92840 | 2011-12-30 |
| Find all providers in zip 92840 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
| 1548813041 | Families Together of Orange County | Clinic/Center | 9918 W. Katella, Suite A, Garden Grove, CA 92804-9280 | 2019-07-23 |
| 1285708818 | Southland Integrated Services, Inc. | Clinic/Center | 9862 Chapman Ave, Garden Grove, CA 92841-2726 | 2006-11-17 |
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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 | ||||
| City | GARDEN GROVE |
| Zip Code | 92840 |
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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.