NPIMap

Organization Active NPI

Coalinga Valley Health Clinics. Inc

Doing business as Leonel Apodaca Jr MD

  • Point of Service
  • Huron, CA
National Provider Identifier
1104955483
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
G66374 Issued in CA
Legal business name
COALINGA VALLEY HEALTH CLINICS. INC
Doing business as
Leonel Apodaca Jr MD
Practice address
36617 Central Ave
Huron, CA 93234-1628
Phone
(559) 945-9251
Fax
(559) 945-2270
NPI assigned
Mar 5, 2007
Last updated
Jul 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Authorized official

Name
Dr. Leonel Apodaca Jr., MDNPI 1699883157
Title
Administrator
Phone
(559) 935-4374

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X G66374 CA Primary

Addresses

Primary practice location

36617 Central Ave
Huron, CA 93234-1628

Mailing address

PO Box 495
Coalinga, CA 93210-0495
Phone (559) 935-4374

Other names 1

  • Leonel Apodaca Jr MD Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030523000043 CA Part A Provider - Rural Health Clinic 3577472323 Practice locations: Huron, CA
O20040518000397 CA Part B Supplier - Clinic/Group Practice 3577472323 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Coalinga, CA; Huron, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104955483. Details of each certification follow.

Rural health clinic certification: CCN 553927

Legal name
COALINGA VALLEY HEALTH CLINICS INC
Doing business as
COALINGA VALLEY HEALTH CLINICS, INC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 26, 2000
Last certification
Nov 16, 2017
Ownership / control type
2B
Most recent change of ownership
Jan 12, 2004 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Jul 28, 2003 in CA
Enrollment address
36617 Central Ave
Huron, CA 93234

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0958896Coalinga Valley Health Clinics Inc36617 Central Avenue, Huron, CA 93234Provider-performed microscopyMar 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Coalinga Valley Health Clinics Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Coalinga Valley Health Clinics Inc Organization, Huron, CA 5% Or Greater Direct Ownership Interest Aug 30, 2007
Leonel Apodaca Individual 5% Or Greater Direct Ownership Interest May 23, 2003
Corporate Director May 23, 2003
W-2 Managing Employee May 23, 2003

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Leonel Apodaca Jr., MDCoalinga, CA, CCN 553916 Rural health clinic 5% Or Greater Direct Ownership Interest Mar 28, 2003

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1104955483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 495",
            "city": "COALINGA",
            "state": "CA",
            "postal_code": "932100495",
            "telephone_number": "559-935-4374",
            "fax_number": "559-935-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36617 CENTRAL AVE",
            "city": "HURON",
            "state": "CA",
            "postal_code": "932341628",
            "telephone_number": "559-945-9251",
            "fax_number": "559-945-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COALINGA VALLEY HEALTH CLINICS. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "APODACA",
        "authorized_official_first_name": "LEONEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "559-935-4374",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CA",
            "license": "G66374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leonel Apodaca Jr MD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Leonel Apodaca Jr MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huron, CA

Sources for this page

Verify at the official NPI Registry.