NPIMap

Organization Active NPI

Westside Family Health Center

  • Clinic/Center
  • Culver City, CA
National Provider Identifier
1407033616
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
EAP11798F Issued in CA
Legal business name
WESTSIDE FAMILY HEALTH CENTER
Practice address
3861 Sepulveda Blvd
Culver City, CA 90230-4605
Phone
(309) 450-4773
Fax
(310) 450-0873
NPI assigned
Jan 30, 2008
Last updated
Aug 25, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Authorized official

Name
Debra Ann Farmer
Title
President/Ceo
Phone
(309) 450-4773

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X EAP11798F CA Primary
Clinic/Center 261Q00000X NU

Addresses

Primary practice location

3861 Sepulveda Blvd
Culver City, CA 90230-4605

Mailing address

3861 Sepulveda Blvd
Culver City, CA 90230-4605
Phone (309) 450-4773

Other identifiers 1

IdentifierTypeStateIssuer
EAP11798FOtherCAEAPC

National Provider Directory

National Provider Directory

Locations

1711 Ocean Park Blvd
Santa Monica, CA 90405
Phone (310) 450-2191

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JAHCCA

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1407033616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3861 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304605",
            "telephone_number": "309-450-4773",
            "fax_number": "310-450-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3861 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304605",
            "telephone_number": "309-450-4773",
            "fax_number": "310-450-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE FAMILY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-30",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "FARMER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "309-450-4773"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "EAP11798F",
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EAPC",
            "identifier": "EAP11798F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.