| Centro Medico Community Clinic, Inc | |
|
11900 Avalon Blvd Ste 100 Los Angeles CA 90061-2867 | |
| (951) 278-8910 | |
| Not Available |
| Full Name | Centro Medico Community Clinic, Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 11900 Avalon Blvd Ste 100, Los Angeles, California |
| Authorized Official Name and Position | Samar Masri (HR DIRECTOR) |
| Authorized Official Contact | 9092416861 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centro Medico Community Clinic, Inc 1303 W 6th St Ste 102 Corona CA 92882-3196 Ph: (951) 278-8910 | Centro Medico Community Clinic, Inc 11900 Avalon Blvd Ste 100 Los Angeles CA 90061-2867 Ph: (951) 278-8910 |
| NPI Number | 1073310355 |
|---|---|
| Provider Enumeration Date | 02/25/2025 |
| Last Update Date | 02/25/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073310355 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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