PEDIATRIC AND FAMILY MEDICAL CENTER


Address: 1921 Maple Ave, Los Angeles, CA 90011-1036
Phone: 2137475542

PEDIATRIC AND FAMILY MEDICAL CENTER (NPI# 1225687197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1225687197
Entity Type Organization
Organization Name PEDIATRIC AND FAMILY MEDICAL CENTER
Other Organization Name EISNER HEALTH STUDENT AND FAMILY WELLNESS CENTER
Practice Address 1921 Maple Ave
Los Angeles
CA 90011-1036
Mailing Address 1530 S Olive St
Los Angeles
CA 90015-3023
Practice Telephone 2137475542
Practice Fax Number 2133423408
Mailing Telephone 2137475542
Mailing Fax Number 2133423408
Enumeration Date 2019-09-04
Last Update Date 2019-09-10
Authorized Official Name WARREN BRODINE (PRESIDENT / CEO)
Authorized Official Telephone 2137461037
Is Organization Subpart Y
Parent Organization Name PEDIATRIC AND FAMILY MEDICAL CENTER

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Eisner Health Doing Business As Name - Organization
Eisner Health Student and Family Wellness Center Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1215586367 Pediatric and Family Medical Center Clinic/Center 5400 Balboa Blvd Ste 131, Encino, CA 91316-5204 2019-09-10
1235641887 Pediatric and Family Medical Center Clinic/Center 15477 Ventura Blvd Unit Lower, Sherman Oaks, CA 91403-3006 2017-11-03
1750917514 Pediatric and Family Medical Center Clinic/Center 8405 Beverly Blvd, Los Angeles, CA 90048-3401 2020-03-12
1225664089 Pediatric and Family Medical Center Clinic/Center 5205 Melrose Ave, Los Angeles, CA 90038-3144 2020-03-12
1760018527 Pediatric and Family Medical Center Clinic/Center 6043 Hollywood Blvd, Los Angeles, CA 90028-5411 2020-03-12
1477103299 Pediatric and Family Medical Center Clinic/Center 15477 Ventura Blvd Ste 100, Sherman Oaks, CA 91403-3046 2019-09-13
1730547019 Pediatric and Family Medical Center Clinic/Center 15251 Roscoe Blvd, Panorama City, CA 91402-4401 2016-02-02
1982075107 Pediatric and Family Medical Center Clinic/Center 15477 Ventura Blvd, Suite 300, Sherman Oaks, CA 91403-3006 2015-10-14
1982075115 Pediatric and Family Medical Center Clinic/Center 6618 Van Nuys Blvd, Van Nuys, CA 91405-4617 2015-10-14
1720468804 Pediatric and Family Medical Center Clinic/Center 1513 S Grand Ave, Suite 220 & 250, Los Angeles, CA 90015-3070 2015-06-04

Office Location

Street Address 1921 MAPLE AVE
City LOS ANGELES
State CA
Zip Code 90011-1036

Providers in the same location

NPI Name Taxonomy Address Enumeration
1184983231 Total Family Support Clinic Case Management 1921 Maple Ave, Los Angeles, CA 90011-1036 2012-05-10

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1184223935 Commercial & Housing Support Aid Assisted Living Facility 120 - 122 East 24th Street, Los Angeles, CA 90011 2020-10-22
1295377711 Joseph D Madrigal Home Health Aide 1977 Anzac Ave, Los Angeles, CA 90011 2019-10-16
1538641212 Brenda Bahena Community Health Worker South Central Family Health Center, 4425 S. Central Ave, Los Angeles, CA 90011 2018-08-30
1083101851 Bronwyn Anne Hazlewood Student in an Organized Health Care Education/Training Program 3740 Maple Ave, 1/2 B, Los Angeles, CA 90011 2018-04-17
1164941183 Kimberly Denise Lister- Gutierrez Counselor 303 E 52nd Street, Los Angeles, CA 90011 2017-09-11
1205252533 Jameese B Smith Case Manager/Care Coordinator 271 E. 43rd Street, Los Angeles, CA 90011 2014-03-11
1033533153 Avalon-carver Community Center Community/Behavioral Health 4920 S. Avalon Blvd, Los Angeles, CA 90011 2014-02-10
1245672500 Kellie D Bougard Student in an Organized Health Care Education/Training Program 4920 South Avalon Blvd, Los Angeles, CA 90011 2013-07-26
1578909404 Ma. Jasmin F Binas Nurse Practitioner 2707 S.central Ave., Los Angeles, CA 90011 2013-05-19
1912343344 California Assisted Pharmacy, Inc Pharmacy 646 E 28th St, Ste #1, Los Angeles, CA 90011 2013-05-13
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Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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
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Competitor

Search similar providers

City LOS ANGELES
Zip Code 90011

Improve Information

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Dataset Information

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.

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