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NPI Code Detail

MEDICARE: FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, INC.

MEDICARE: FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, 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
1261Q00000XClinic/Center
2261QC1500XCommunity Health Clinic/Center
3261QF0050XNon-Surgical Family Planning Clinic/CenterCA
4261QH0100XHealth Service Clinic/CenterCA
53336C0002XClinic Pharmacy
63336C0003XCommunity/Retail Pharmacy
7261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1922416411
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, INC.
Provider Business Mailing Address
First Line : 6001 E WASHINGTON BLVD STE 101
Second Line :
City : COMMERCE
State : CA
Zip : 90040-2455
Country : US
Telephone Number : 562-928-9600
Fax Number : 562-927-8603
Provider Business Practice Location Address
First Line : 6001 E WASHINGTON BLVD # 100
Second Line :
City : COMMERCE
State : CA
Zip : 90040-2451
Country : US
Telephone Number : 562-928-9600
Fax Number : 323-447-1738
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MRS. RAQUEL R. VILLA
Credential :
Telephone Number : 562-776-5014
Provider Enumeration Date : 07/28/2014
Last Update Date : 04/10/2025

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