NPIMap

Organization Active NPI

Central City Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Upland, CA
National Provider Identifier
1174996318
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CENTRAL CITY COMMUNITY HEALTH CENTER INC
Practice address
268 McArthur Way Ste a
Upland, CA 91786-5615
Phone
(909) 920-1165
NPI assigned
Nov 10, 2015
Last updated
Dec 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Authorized official

Name
Rosemary Reyes, MDNPI 1619105327
Title
Ceo
Phone
(714) 490-2750

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
Federally Qualified Health Center (FQHC) 261QF0400X CA Primary

Addresses

Primary practice location

268 McArthur Way Ste a
Upland, CA 91786-5615

Mailing address

2019 Saturn St
Monterey Park, CA 91755-7415
Phone (323) 724-0019

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041025001177 CA Part B Supplier - Clinic/Group Practice 6608837331 Receives reassigned benefits from 105 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: El Monte, CA; Upland, CA; Stanton, CA; Norco, CA; Los Angeles, CA; La Puente, CA; Indio, CA; Garden Grove, CA…
O20260310003091 CA Part A Provider - Federally Qualified Health Center (FQHC) 6608837331 Practice locations: Upland, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174996318. Details of each certification follow.

Federally qualified health center certification: CCN A11029

Legal name
CENTRAL CITY COMMUNITY HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 22, 2025
Last certification
Oct 22, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
268 McArthur Way
Ste a
Upland, CA 91786

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Central City Community Health Center14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

4160 Maine Ave
Baldwin Park, CA 91706
Phone (323) 724-0019

12511 Brookhurst St
Fl 2
Garden Grove, CA 92840
Phone (714) 643-7176

82420 Miles Ave
Indio, CA 92201
Phone (760) 342-3336

268 McArthur Way
Ste A
Upland, CA 91786
Phone (909) 406-5353

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Juan Duran Individual Corporate DirectorBoard Member Jan 1, 2010
Violeta Wang Individual Corporate DirectorBoard Treasurer Jan 1, 2018
Rosemary David Reyes Individual Corporate OfficerChief Executive Officer Jun 1, 2021
W-2 Managing EmployeeCeo Jun 1, 2021
Melana Smith Individual Corporate DirectorBoard Member Jan 1, 2019
Larry Landless Individual Corporate DirectorBoard Secretary Jan 1, 2019
Dee Libertine Individual Corporate DirectorBoard Member Jan 1, 2021

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 96

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.

View all 96

NPI Registry JSON

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1174996318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 SATURN ST",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917557415",
            "telephone_number": "323-724-0019",
            "fax_number": "323-248-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 MCARTHUR WAY STE A",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865615",
            "telephone_number": "909-920-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CITY COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-10",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-490-2750",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.