NPIMap

Organization Active NPI

Pediatric and Family Medical Center

  • Federally Qualified Health Center (FQHC)
  • Encino, CA
National Provider Identifier
1215586367
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PEDIATRIC AND FAMILY MEDICAL CENTER
Practice address
5400 Balboa Blvd Ste 131
Encino, CA 91316-5204
Phone
(213) 747-5542
NPI assigned
Sep 10, 2019
Organization subpart
Yes
Parent organization
PEDIATRIC AND FAMILY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
Monica McCarthy
Title
Sr VP, Coo & Interim Ceo
Phone
(213) 747-5542

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

5400 Balboa Blvd Ste 131
Encino, CA 91316-5204

Mailing address

1530 S Olive St
Los Angeles, CA 90015-3023
Phone (213) 747-5542

Other names 1

  • EISNER HEALTH OPTOMETRY AT ENCINO Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Family Medical C13 organizations share this tax ID, including this one
Part of
Pediatric Family Medical C

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1215586367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 S OLIVE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153023",
            "telephone_number": "213-747-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 BALBOA BLVD STE 131",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913165204",
            "telephone_number": "213-747-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC AND FAMILY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEDIATRIC AND FAMILY MEDICAL CENTER",
        "enumeration_date": "2019-09-10",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "SR VP, COO & INTERIM CEO",
        "authorized_official_telephone_number": "213-747-5542"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EISNER HEALTH OPTOMETRY AT ENCINO",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EISNER HEALTH OPTOMETRY AT ENCINO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.