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General NPI Number Information
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NPI Number | 1710699483
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE COMMUNITY HEALTH CENTERS, INC.
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Dates
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Enumeration Date | 12/14/2022
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 8316 FOOTHILL BLVD
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City | SUNLAND
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State | CA
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Zip | 91040
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Country | US
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Telephone | 818-273-8929
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Fax | 818-844-5090
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Provider Business Mailing Address
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Address Line | 801 S. CHEVY CHASE DR. #20
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City | GLENDALE
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State | CA
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Zip | 91205
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Country | US
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Telephone | 818-630-6101
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Fax | 818-844-5085
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Authorized Official
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Title or Position | COO
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Name | FLORA POLADYAN
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Credential |
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Telephone | 818-630-6106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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