MEDICARE: CENTRAL CITY COMMUNITY HEALTH CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician
2	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1285788059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL CITY COMMUNITY HEALTH CENTER INC

Provider Business Mailing Address
First Line	:	2019 SATURN ST
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91755-7415
Country	:	US
Telephone Number	:	323-724-0019
Fax Number	:	323-248-7044

Provider Business Practice Location Address
First Line	:	2237 W BALL RD
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804
Country	:	US
Telephone Number	:	714-490-2750
Fax Number	:	714-490-2757

Authorized Official
Title or Position	:	CEO
Name	:	ROSEMARY D REYES
Credential	:	DO
Telephone Number	:	323-724-0019

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	12/16/2025

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