Healthcare Provider Details

I. General information

NPI: 1215310008
Provider Name (Legal Business Name): FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2015
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6119 AGRA ST
BELL GARDENS CA
90201-1705
US

IV. Provider business mailing address

6001 E WASHINGTON BLVD STE 100
COMMERCE CA
90040-2451
US

V. Phone/Fax

Practice location:
  • Phone: 562-928-9600
  • Fax:
Mailing address:
  • Phone: 562-928-9600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MRS. RAQUEL R VILLA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 562-776-5014