Healthcare Provider Details

I. General information

NPI: 1326974643
Provider Name (Legal Business Name): TRI-STATE COMMUNITY HEALTHCARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31739 RIVERSIDE DR STE A1
LAKE ELSINORE CA
92530-7818
US

IV. Provider business mailing address

1535 E COLORADO ST
GLENDALE CA
91205-1513
US

V. Phone/Fax

Practice location:
  • Phone: 951-245-0505
  • Fax: 951-245-0999
Mailing address:
  • Phone: 747-221-3530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: ARAM MANOUKIAN
Title or Position: CEO
Credential:
Phone: 760-326-0222