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).
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 |
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 Name | Type Code |
---|---|
Eisner Health | Doing Business As Name - Organization |
Eisner Health Student and Family Wellness Center | Doing Business As Name - Organization |
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 |
Street Address |
1921 MAPLE AVE |
City | LOS ANGELES |
State | CA |
Zip Code | 90011-1036 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184983231 | Total Family Support Clinic | Case Management | 1921 Maple Ave, Los Angeles, CA 90011-1036 | 2012-05-10 |
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 |
Find all providers in zip 90011 |
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 |
---|---|---|---|---|
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 | 90011 |
Please comment or provide details below to improve the information on PEDIATRIC AND FAMILY MEDICAL CENTER.
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.