QUEENSCARE HEALTH CENTERS (NPI# 1104075282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104075282 |
| Entity Type | Organization |
| Organization Name | QUEENSCARE HEALTH CENTERS |
| Other Organization Name | QUEENSCARE HEALTH CENTERS |
| Practice Address |
4816 E 3rd St Los Angeles CA 90022-1602 |
| Mailing Address |
950 S Grand Ave 2nd Floor South Los Angeles CA 90015-4202 |
| Practice Telephone | 3237804510 |
| Practice Fax Number | 3237806132 |
| Mailing Telephone | 3237804510 |
| Mailing Fax Number | 3237806132 |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2015-01-16 |
| Authorized Official Name | MRS. BARBARA B HINES (PRESIDENT AND 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) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE PROVIDER NUMBER | W6997D | 01 |
| CA | MEDICARE FQHC PROVIDER NUMBER | 55-1019 | 01 |
| CA | CMM70660F | 05 |
| Other Name | Type Code |
|---|---|
| QueensCare Health Centers | 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 |
| 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 |
| 1093886251 | Queenscare Health Centers | Clinic/Center | 184 Bimini Pl, Los Angeles, CA 90004-5903 | 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 |
4816 E 3RD ST |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90022-1602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811980634 | Claudia Ramos-smulevich | Pediatrics | 4816 E 3rd St, Los Angeles, CA 90022-1602 | 2005-08-26 |
| 1437717402 | Bryan Pham | Pharmacist | 4816 E 3rd St, Los Angeles, CA 90022-1602 | 2019-06-04 |
| 1780121988 | Ana Han Ly | Pharmacist | 4816 E 3rd St, Los Angeles, CA 90022-1602 | 2017-01-25 |
| 1356892343 | Gena Catherine Craemer | Nurse Practitioner | 4816 E 3rd St, Los Angeles, CA 90022-1602 | 2016-10-14 |
| 1992159412 | Sangeeta Salvi | Pharmacist | 4816 E 3rd St, Los Angeles, CA 90022-1602 | 2016-04-21 |
| 1447630256 | Maria Magdalena Guerra-manalo | Pharmacist | 4816 E 3rd St, Los Angeles, CA 90022-1602 | 2015-06-06 |
| 1992106082 | Queenscare Health Centers | Pharmacy | 4816 E 3rd St, Los Angeles, CA 90022-1602 | 2014-09-09 |
| 1538578109 | Douglas P. Ahern | Nurse Practitioner | 4816 E 3rd St, Los Angeles, CA 90022-1602 | 2014-08-08 |
| 1154736684 | Cory Clement | Podiatrist | 4816 E 3rd St, Los Angeles, CA 90022-1602 | 2014-06-23 |
| 1811316151 | Hla Moe | Internal Medicine | 4816 E 3rd St, Los Angeles, CA 90022-1602 | 2014-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700405701 | Altamed Health Services Corp | Pharmacy | 972 Goodrich Blvd Rm 100, Los Angeles, CA 90022 | 2020-04-10 |
| 1033699426 | Reachwell Home Health Inc | Home Health | 236 1/4 S Atlantic Blvd, Los Angeles, CA 90022 | 2018-08-15 |
| 1326528704 | Shelli Hernandez | Community Health Worker | Enki Health & Research Systems Inc., 1000 Goodrich Blvd., Commerce, CA 90022 | 2018-08-15 |
| 1477071660 | East Los Angeles Womens Center | Counselor | 1431 S. Atlantic Blvd, Los Angeles, CA 90022 | 2017-09-07 |
| 1467974824 | Ena Vilma Hernandez | Registered Nurse | 245 S Fetterly St, Los Angeles, CA 90022 | 2017-07-07 |
| 1437688843 | Maud D Legaspi | Social Worker | 5425 E. Pomona Blvd, Los Angeles, CA 90022 | 2017-06-08 |
| 1548793920 | Harbor Chiropractic, Inc., A Bahan Company | Chiropractor | 5301 Whittier Blvd, Atrium Lower Level, Los Angeles, CA 90022 | 2017-04-04 |
| 1326590423 | Via Care Community Health Center | Clinic/Center | 501 S. Woods Ave, Los Angeles, CA 90022 | 2016-10-25 |
| 1780057950 | Monica Poomiwatracanont | Pharmacist | 5176 E. Whittier Blvd., Los Angeles, CA 90022 | 2015-11-10 |
| 1609277433 | Ethan C. A Lee Dental Inc. | Dentist | 6046 Whittier Blvd., Los Angeles, CA 90022 | 2014-09-11 |
| Find all providers in zip 90022 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
| 1184224156 | Via Care Community Health Center | Clinic/Center | 400 West Washington Blvd., The Hub D3-room 107, Los Angeles, CA 90015 | 2020-10-29 |
| 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 | 90022 |
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.