Healthcare Provider Details

I. General information

NPI: 1063835213
Provider Name (Legal Business Name): HERALD CHRISTIAN HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2014
Last Update Date: 10/11/2021
Certification Date: 10/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 HANOVER RD STE 103
CITY OF INDUSTRY CA
91748-1796
US

IV. Provider business mailing address

3401 AERO JET AVE
EL MONTE CA
91731-2801
US

V. Phone/Fax

Practice location:
  • Phone: 626-286-8700
  • Fax: 626-286-8650
Mailing address:
  • Phone: 626-286-8700
  • Fax: 626-286-8650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number550003224
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number550000475
License Number StateCA

VIII. Authorized Official

Name: MS. EMILY SZETO
Title or Position: CHIEF ADMINISTRATION OFFICER
Credential:
Phone: 626-286-8700