NPIMap

Organization Active NPI

Precision Health Center

  • Health Service Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1205412244
Registry record updated Mar 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
PRECISION HEALTH CENTER
Practice address
709 N Hill St Ste 18
Los Angeles, CA 90012-2352
Phone
(213) 687-0888
NPI assigned
Mar 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2021

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

Authorized official

Name
Mr. Romeo V Herrera
Title
Chief Operating Officer
Phone
(310) 407-9331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

709 N Hill St Ste 18
Los Angeles, CA 90012-2352

Mailing address

709 N Hill St Ste 18
Los Angeles, CA 90012-2352
Phone (213) 687-0888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20220211000826 CA Part B Supplier - Clinic/Group Practice 4486047628 Receives reassigned benefits from 6 practitioners
Practice locations: Huntington Park, CA; Los Angeles, CA
O20221212002704 CA Part A Provider - Federally Qualified Health Center (FQHC) 4486047628 Practice locations: Los Angeles, CA
O20231129002171 CA Part A Provider - Federally Qualified Health Center (FQHC) 4486047628 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Huntington Park, CA

Federally qualified health center certification: CCN A01136

Legal name
PRECISION HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 28, 2022
Last certification
Nov 28, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 30, 2021 in CA
Enrollment address
709 N Hill St
Ste 18
Los Angeles, CA 90012-2352

Federally qualified health center certification: CCN A01817

Legal name
PRECISION HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 20, 2023
Last certification
Nov 20, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 30, 2021 in CA
Enrollment address
2568 Clarendon Ave
Huntington Park, CA 90255-4073

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.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Hector Verdugo Individual Corporate DirectorBoard Member Feb 20, 2021
Corporate DirectorBoard of Directors Feb 1, 2021
Jesus Parada Individual Corporate Director Apr 26, 2021
Corporate DirectorVice Chairperson Feb 1, 2021
John Negrete Individual Corporate DirectorBoard Member Feb 1, 2021
Mabel Chan Individual Corporate Director May 21, 2021
Corporate DirectorBoard of Directors Feb 1, 2021
Hung Duong Individual Corporate DirectorBoard Member Feb 1, 2022
Corporate DirectorBoard of Directors Jan 26, 2022
Xiayi Zhang Individual Corporate Director Jul 27, 2022
Corporate DirectorSecretary Jan 26, 2022
Than a Luu Individual Corporate OfficerChief Medical Officer Jan 1, 2021
W-2 Managing EmployeeChief Medical Officer Jan 1, 2021
George Yu Individual Corporate DirectorBoard Member Feb 11, 2021
Corporate DirectorBoard of Directors Feb 1, 2021
Jimmy Ung Individual Corporate OfficerChief Executive Officer Jan 1, 2021
W-2 Managing EmployeeChief Executive Officer Jan 1, 2021
W-2 Managing EmployeeChief Executive Officer Jan 1, 2023
Ashley Thompson Individual Corporate DirectorBoard Member Feb 1, 2022
Corporate DirectorTreasurer Feb 1, 2021
Bryan Ruiz Individual Corporate DirectorBoard Member Feb 1, 2022
Corporate DirectorChairperson Feb 1, 2021
Spencer Lok Yee Wong Individual Corporate DirectorBoard of Directors Aug 1, 2023
James Min Individual Corporate DirectorBoard of Directors Aug 1, 2023

Owners & managing parties with NPI records 1

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

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1616284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616284800000",
    "number": "1205412244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 N HILL ST STE 18",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900122352",
            "telephone_number": "213-687-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 N HILL ST STE 18",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900122352",
            "telephone_number": "213-687-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-21",
        "last_updated": "2021-03-21",
        "certification_date": "2021-03-21",
        "status": "A",
        "authorized_official_last_name": "HERRERA",
        "authorized_official_first_name": "ROMEO",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "310-407-9331",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.