NPIMap

Organization Active NPI

Centro Medico Communty Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Corona, CA
National Provider Identifier
1245366715
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CENTRO MEDICO COMMUNTY CLINIC INC
Practice address
1303 W 6TH St Ste 105
Corona, CA 92882-3196
Phone
(951) 278-8910
Fax
(951) 278-9895
NPI assigned
Feb 26, 2007
Last updated
Apr 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Authorized official

Name
Ms. Samar Masri
Title
HR/Financial Coordinator
Phone
(909) 278-8910

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X HAP70911G CA
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

1303 W 6TH St Ste 105
Corona, CA 92882-3196

Mailing address

1303 W 6TH St Ste 102
Corona, CA 92882-3196
Phone (951) 278-8910

National Provider Directory

National Provider Directory
Tax ID family
Centro Medico Communty Clinic Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

1303 W 6th St
Ste 105
Corona, CA 92882
Phone (951) 278-8910

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1245366715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 W 6TH ST STE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823196",
            "telephone_number": "951-278-8910",
            "fax_number": "951-278-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 W 6TH ST STE 105",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823196",
            "telephone_number": "951-278-8910",
            "fax_number": "951-278-9895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO MEDICO COMMUNTY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "MASRI",
        "authorized_official_first_name": "SAMAR",
        "authorized_official_title_or_position": "HR/FINANCIAL COORDINATOR",
        "authorized_official_telephone_number": "909-278-8910",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "HAP70911G",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.