Healthcare Provider Details

I. General information

NPI: 1104367572
Provider Name (Legal Business Name): CENTER FOR FAMILY HEALTH AND EDUCATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2017
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3229 SANTA ANITA AVE FL 1
EL MONTE CA
91733-1359
US

IV. Provider business mailing address

6609 VAN NUYS BLVD STE 201-A
VAN NUYS CA
91405-4618
US

V. Phone/Fax

Practice location:
  • Phone: 626-575-4584
  • Fax:
Mailing address:
  • Phone: 818-812-5410
  • Fax: 818-812-5410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number550002136
License Number StateCA

VIII. Authorized Official

Name: DARYOUSH KASHANI
Title or Position: CEO
Credential: M.D.
Phone: 818-899-5555