Healthcare Provider Details

I. General information

NPI: 1609748714
Provider Name (Legal Business Name): UNION STREET COMMUNITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7840 IMPERIAL HWY STE B
DOWNEY CA
90242-3457
US

IV. Provider business mailing address

955 CARRILLO DR STE 750
LOS ANGELES CA
90048-5400
US

V. Phone/Fax

Practice location:
  • Phone: 424-258-0124
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL GHODS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 424-258-0124