NPIMap

Organization Active NPI

Centro Medico Community Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Corona, CA
National Provider Identifier
1013856020
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CENTRO MEDICO COMMUNITY CLINIC, INC
Practice address
1307 W 6TH St Ste 124
Corona, CA 92882-1642
Phone
(844) 223-6876
NPI assigned
Mar 25, 2026
Last updated
Apr 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Samar Masri
Title
HR Director
Phone
(951) 278-8910

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1307 W 6TH St Ste 124
Corona, CA 92882-1642

Mailing address

1303 W 6TH St Ste 102
Corona, CA 92882-3196
Phone (844) 223-6876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013856020. Details of each certification follow.

  • CCN 751017 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 751017

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CENTRO MEDICO COMMUNITY CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 10, 2013
Last certification
Jun 10, 2013
Ownership / control type
For profit – corporation
Facility address
1307 West 6TH Street, Suite 113
Corona, CA 92882

National Provider Directory

National Provider Directory
Tax ID family
Centro Medico Communty Clinic Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1307 W 6th St
Ste 124
Corona, CA 92882
Phone (844) 223-6876

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1774396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775779200000",
    "number": "1013856020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 W 6TH ST STE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823196",
            "telephone_number": "844-223-6876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 W 6TH ST STE 124",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928821642",
            "telephone_number": "844-223-6876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO MEDICO COMMUNITY CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-25",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A",
        "authorized_official_last_name": "MASRI",
        "authorized_official_first_name": "SAMAR",
        "authorized_official_title_or_position": "HR DIRECTOR",
        "authorized_official_telephone_number": "951-278-8910"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.