CENTRAL CITY COMMUNITY HEALTH CENTER NPI 1508254814

NPI Information

NPI: 1508254814
Provider Name: CENTRAL CITY COMMUNITY HEALTH CENTER
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 05D0885390

Address:
81709 DR CARREON BLVD STE E1
INDIO, CA
ZIP 92201
Phone: (760) 342-3336
Get Directions

CENTRAL CITY COMMUNITY HEALTH CENTER is a federally qualified health center (fqhc) clinic center in Indio, CA. CENTRAL CITY COMMUNITY HEALTH CENTER NPI is 1508254814. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

81709 DR CARREON BLVD STE E1
INDIO, CA
ZIP 92201-589
Phone: (760) 342-3336
Fax: (866) 997-9757

The provider's authorized official is Rosemary D Reyes .
The authorized official title is Ceo and has the following contact phone number (323) 724-0019.

The CLIA number assigned to this NPI record is 05D0885390 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/8/2015 and was last updated on 12/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice				No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1033488416	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »