NPIMap

Organization Active NPI

Centro Medico Community Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Phelan, CA
National Provider Identifier
1316831407
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CENTRO MEDICO COMMUNITY CLINIC, INC
Practice address
3936 Phelan Rd Ste A1
Phelan, CA 92371-4142
Phone
(951) 278-8910
NPI assigned
Jun 4, 2025
Last updated
Jun 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Authorized official

Name
Ms. Samar Masri
Title
HR Director
Phone
(951) 376-3097

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

3936 Phelan Rd Ste A1
Phelan, CA 92371-4142

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 102
Corona, CA 92882

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1748995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748995200000",
    "number": "1316831407",
    "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": "951-376-3097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3936 PHELAN RD STE A1",
            "city": "PHELAN",
            "state": "CA",
            "postal_code": "923714142",
            "telephone_number": "951-278-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO MEDICO COMMUNITY CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-04",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A",
        "authorized_official_last_name": "MASRI",
        "authorized_official_first_name": "SAMAR",
        "authorized_official_title_or_position": "HR DIRECTOR",
        "authorized_official_telephone_number": "951-376-3097",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "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 Phelan, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.