NPIMap

Organization Active NPI

Unicare Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pomona, CA
National Provider Identifier
1356763155
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
UNICARE COMMUNITY HEALTH CENTER, INC.
Practice address
1501 E Holt Ave Ste a
Pomona, CA 91767-5823
Phone
(909) 623-3600
Fax
(909) 623-3383
NPI assigned
Jan 13, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Authorized official

Name
Avetik Machkalyan
Title
Chief Executive Officer
Phone
(909) 623-3600

Specialties & licenses 2

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

Addresses

Primary practice location

1501 E Holt Ave Ste a
Pomona, CA 91767-5823

Mailing address

437 N Euclid Ave
Ontario, CA 91762-3456
Phone (909) 988-2555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150623001589 CA Part B Supplier - Clinic/Group Practice 8426369067 Receives reassigned benefits from 141 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Colton, CA; Apple Valley, CA; San Bernardino, CA; Riverside, CA; Pomona, CA; Pacoima, CA; Ontario, CA; Los Angeles, CA…
O20151218001167 CA Part A Provider - Federally Qualified Health Center (FQHC) 8426369067 Practice locations: Pomona, CA

Federally qualified health center certification: CCN 751827

Legal name
UNICARE COMMUNITY HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 26, 2015
Last certification
Oct 26, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 27, 1999 in CA
Enrollment address
1501 E Holt Ave
Ste a
Pomona, CA 91767-5823

Other NPIs with the same Medicare PAC ID 17

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

View all 17

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2089456Unicare Community Health Center, Inc1501 E Holt Ave Ste a, Pomona, CA 91767Certificate of waiverDec 29, 2026

National Provider Directory

National Provider Directory

Locations

985 W Vernon Ave
Los Angeles, CA 90037
Phone (323) 234-6300

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Monica E Palma Individual Corporate DirectorBoard Member Dec 14, 2013
Nancy M Herrera Individual Corporate DirectorBoard Secretary Dec 14, 2013
Avetik Machkalyan Individual Corporate OfficerCeo Jan 21, 2014
W-2 Managing EmployeeCeo Jan 21, 2014
Garegin Pogosian Individual Corporate OfficerCfo Jan 21, 2014
W-2 Managing EmployeeCfo Jan 21, 2014
Vahan Grigoryan Individual Corporate DirectorBoard Member Dec 14, 2013
Alma R Enciso Individual Corporate DirectorBoard Member Dec 20, 2013
Kelly H Vo Individual Corporate OfficerVice President Jan 21, 2014
Amy R Mills Individual Corporate DirectorBoard Chair Dec 14, 2013
Ramona Gutierrez Individual Corporate DirectorBoard Member Dec 14, 2013
Heidy L Garcia Cardona Individual Corporate DirectorBoard Treasurer Feb 18, 2015
Eduard Gyadukyan Individual Corporate OfficerCoo Jan 21, 2014
W-2 Managing EmployeeCoo Jan 21, 2014
Christina M Salazar Individual Corporate DirectorBoard Member Apr 14, 2015
Armen Y Nercessian Individual Corporate OfficerCmo Jan 21, 2014
Laura M Burger Individual Corporate DirectorBoard Member Dec 14, 2013
Natalie Brewer Individual Corporate DirectorBoard Vice-Chair Dec 14, 2013

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 9

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": "1389571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1356763155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 N EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917623456",
            "telephone_number": "909-988-2555",
            "fax_number": "909-391-3081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E HOLT AVE STE A",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675823",
            "telephone_number": "909-623-3600",
            "fax_number": "909-623-3383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNICARE COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-13",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "MACHKALYAN",
        "authorized_official_first_name": "AVETIK",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "909-623-3600"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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 Pomona, CA

Sources for this page

Verify at the official NPI Registry.