SOUTH CENTRAL FAMILY HEALTH CENTER (NPI# 1578089447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578089447 |
| Entity Type | Organization |
| Organization Name | SOUTH CENTRAL FAMILY HEALTH CENTER |
| Other Organization Name | SOUTH CENTRAL FAMILY DENTAL & MEDICAL |
| Practice Address |
4415 S Central Ave Los Angeles CA 90011-3629 |
| Mailing Address |
4425 S Central Ave Los Angeles CA 90011-3629 |
| Practice Telephone | 3239084200 |
| Practice Fax Number | 3234324330 |
| Mailing Telephone | (323) 908-4247 |
| Mailing Fax Number | 3239084256 |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2017-08-23 |
| Authorized Official Name | MR. RICHARD VELOZ (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 3239084247 |
| Authorized Official Credential | JD |
| 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 |
| Other Name | Type Code |
|---|---|
| South Central Family Dental & Medical | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649792615 | South Central Family Health Center | Clinic/Center | 1028 E Vernon Ave, Los Angeles, CA 90011-3717 | 2017-07-12 |
| 1851847982 | South Central Family Health Center | Pharmacy | 1109 E Vernon Ave, Los Angeles, CA 90011-3718 | 2016-08-29 |
| 1982063939 | South Central Family Health Center | Clinic/Center | 7910 Atlantic Ave Ste M, Cudahy, CA 90201-5774 | 2016-02-18 |
| 1669799896 | South Central Family Health Center | Clinic/Center | 2680 Saturn Ave Ste 220&280, Huntington Park, CA 90255-4377 | 2010-04-28 |
| 1487218970 | South Central Family Health Center | Clinic/Center | 7300 Santa Fe Ave, Huntington Park, CA 90255-5731 | 2019-04-30 |
| 1396891909 | South Central Family Health Center | Clinic/Center | 4425 S Central Ave, Los Angeles, CA 90011-3629 | 2007-01-26 |
| Street Address |
4415 S CENTRAL AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90011-3629 |
| 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... |
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| 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 SOUTH CENTRAL FAMILY HEALTH 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.