Healthcare Provider Details

I. General information

NPI: 1912859901
Provider Name (Legal Business Name): COMPREHENSIVE COMMUNITY HEALTH CENTERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8316 FOOTHILL BLVD SATELLITE MOBILE CLINIC 2
SUNLAND CA
91040-2850
US

IV. Provider business mailing address

801 S CHEVY CHASE DR STE 250
GLENDALE CA
91205-4433
US

V. Phone/Fax

Practice location:
  • Phone: 818-630-6106
  • Fax: 818-844-5085
Mailing address:
  • Phone: 818-630-6106
  • Fax: 818-844-5085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: FLORA POLADYAN
Title or Position: COO
Credential:
Phone: 818-630-6106