MEDICARE: UNICARE COMMUNITY HEALTH CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1144111980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNICARE COMMUNITY HEALTH CENTER, INC.

Provider Business Mailing Address
First Line	:	437 N EUCLID AVE
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91762-3456
Country	:	US
Telephone Number	:	909-749-1835
Fax Number	:

Provider Business Practice Location Address
First Line	:	985 W VERNON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90037-3038
Country	:	US
Telephone Number	:	323-234-6300
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE VICE PRESIDENT
Name	:	KELLY HONG VO
Credential	:
Telephone Number	:	909-749-1835

Provider Enumeration Date	:	07/10/2025
Last Update Date	:	07/10/2025

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