NPIMap

Organization Active NPI

Clinica Monsignor Oscar a. Romero

  • Federally Qualified Health Center (FQHC)
  • Canoga Park, CA
National Provider Identifier
1245966886
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CLINICA MONSIGNOR OSCAR A. ROMERO
Practice address
21013 Sherman Way Ste 4
Canoga Park, CA 91303-3675
Phone
(818) 887-9697
Fax
(818) 887-9495
NPI assigned
Jul 26, 2022
Last updated
Jul 26, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CLINICA MONSIGNOR OSCAR A. ROMEROAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Authorized official

Name
Romeo V Herrera
Title
Director of Compliance
Phone
(310) 407-9331

Specialties & licenses 1

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

Addresses

Primary practice location

21013 Sherman Way Ste 4
Canoga Park, CA 91303-3675

Mailing address

21013 Sherman Way Ste 4
Canoga Park, CA 91303-3675
Phone (818) 887-9697

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250714004040 CA Part A Provider - Federally Qualified Health Center (FQHC) 2264490218 Practice locations: Canoga Park, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245966886. Details of each certification follow.

Federally qualified health center certification: CCN A01964

Legal name
CLINICA MONSIGNOR OSCAR A. ROMERO
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 16, 2025
Last certification
Jun 16, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
21013 Sherman Way
Ste 4
Canoga Park, CA 91303-3675

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Clinica MSR Oscar a Rom12 organizations share this tax ID, including this one
Part of
Clinica MSR Oscar a Rom

Other organizations with this tax ID 11

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

Locations

21013 Sherman Way
Ste 4
Canoga Park, CA 91303
Phone (818) 887-1209

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Marin Castillo Individual Corporate DirectorMember, Board of Directors Jan 1, 2022
Armando Carranza Individual Corporate DirectorSecretary of the Board of Directors Jan 1, 2022
Jose Hernandez Individual Corporate DirectorTreasurer of the Board of Directors Jan 1, 2022
Jose Ruiz Individual Corporate DirectorMember, Board of Directors Jan 1, 2022
Mario Hercules Individual Corporate DirectorMember, Board of Directors Jan 1, 2022
Sandra Gonzalez Individual Corporate DirectorMember, Board of Directors Jan 1, 2022
Santos Fernandez Individual Corporate DirectorMember, Board of Directors Jan 1, 2022
Lizeth Chicas Individual Corporate DirectorMember, Board of Directors Jan 1, 2020
Sonia Molina Individual Corporate DirectorPresident of the Board of Directors Jan 1, 2022
Carlos Hernandez Vaquerano Individual Corporate OfficerCeo Oct 1, 2018 100%
W-2 Managing EmployeeCeo Oct 1, 2018 100%

Practitioners & affiliated clinicians

Practitioners 25

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 25

NPI Registry JSON

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658793600000",
    "number": "1245966886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21013 SHERMAN WAY STE 4",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913033675",
            "telephone_number": "818-887-9697",
            "fax_number": "818-887-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21013 SHERMAN WAY STE 4",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913033675",
            "telephone_number": "818-887-9697",
            "fax_number": "818-887-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA MONSIGNOR OSCAR A. ROMERO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLINICA MONSIGNOR OSCAR A. ROMERO",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A",
        "authorized_official_last_name": "HERRERA",
        "authorized_official_first_name": "ROMEO",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "310-407-9331"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canoga Park, CA

Sources for this page

Verify at the official NPI Registry.