Active NPI
Hope Community Care Clinic, Inc.
- Multi-Specialty Clinic/Center
- Glendale, CA
National Provider Identifier
1043861966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- Legal business name
- HOPE COMMUNITY CARE CLINIC, INC.
- Practice address
- 716 W Broadway
Glendale, CA 91204-1010 - Phone
- (818) 243-9999
- NPI assigned
- Sep 23, 2019
- Organization subpart
- Yes
- Parent organization
- HOPE COMMUNITY CARE CLINIC, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Angel Samvalian
- Title
- Ceo
- Phone
- (818) 243-9999
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Primary |
Addresses
Primary practice location
716 W Broadway
Glendale, CA 91204-1010
Mailing address
716 W Broadway
Glendale, CA 91204-1010
Phone (818) 243-9999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160307001680 | CA | Part B Supplier - Clinic/Group Practice | 8426354143 |
Receives reassigned benefits from 1 practitioner 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Calexico, CA |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Community Health Clinic/Center
- Calexico, CA
- NPI 1720853237
O20160307001680
-
- Multi-Specialty Clinic/Center
- San Fernando, CA
- NPI 1114382421
O20160307001680
National Provider Directory
National Provider Directory- Tax ID family
- Hope Community Care Clinic Inc
- Part of
- Hope Community Care Clinic Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community Health Clinic/Center
- Calexico, CA
- NPI 1720853237
-
- Multi-Specialty Clinic/Center
- San Fernando, CA
- NPI 1114382421
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569196800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1700006400000",
"number": "1043861966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "716 W BROADWAY",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912041010",
"telephone_number": "818-243-9999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "716 W BROADWAY",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912041010",
"telephone_number": "818-243-9999"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOPE COMMUNITY CARE CLINIC, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "HOPE COMMUNITY CARE CLINIC, INC.",
"enumeration_date": "2019-09-23",
"last_updated": "2023-11-15",
"certification_date": "2023-01-10",
"status": "A",
"authorized_official_last_name": "SAMVALIAN",
"authorized_official_first_name": "ANGEL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "818-243-9999"
},
"taxonomies": [
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.