NPIMap

Organization Active NPI

Los Angeles LGBT Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
National Provider Identifier
1467057166
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LOS ANGELES LGBT CENTER
Practice address
2313 W Martin Luther King Jr Blvd
Los Angeles, CA 90008-2724
Phone
(323) 860-3799
NPI assigned
Dec 1, 2020
Organization subpart
Yes
Parent organization
LOS ANGELES LGBT CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Authorized official

Name
Robyn Goldman
Title
Chief Financial Officer
Phone
(323) 993-8948

Specialties & licenses 1

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

Addresses

Primary practice location

2313 W Martin Luther King Jr Blvd
Los Angeles, CA 90008-2724

Mailing address

1625 Schrader Blvd
Los Angeles, CA 90028-6213
Phone (323) 993-7605

Other names 1

  • Los Angeles LGBT Center - Center South Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210602001948 CA Part A Provider - Federally Qualified Health Center (FQHC) 8729975453 Practice locations: Los Angeles, CA

Federally qualified health center certification: CCN 921966

Legal name
LOS ANGELES LGBT CENTER
Doing business as
CENTER SOUTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 2, 2021
Last certification
Jun 2, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 4, 1972 in CA
Enrollment address
2313 W Martin Luther King Jr Blvd
Los Angeles, CA 90008-2724

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
Los Angeles LGBT Center7 organizations share this tax ID, including this one
Part of
Los Angeles LGBT Center

Other organizations with this tax ID 6

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

Locations

2313 W Martin Luther King Jr Blvd
Los Angeles, CA 90008
Phone (323) 860-3799

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Marki Knox Individual Corporate Director Jan 1, 2005
Amy Yanow Individual Corporate Director Sep 1, 2018
Andrew Ortiz Individual Corporate DirectorMember - Board of Directors Jan 1, 2022
Alfred Fraijo Individual Corporate Director Feb 1, 2018
Teresa Ayers Individual Corporate Director Sep 1, 2015
Francisco Ramos Individual Corporate DirectorMember - Board of Directors Jan 1, 2022
Jordan Held Individual Corporate Director Jan 1, 2021
Joseph Robert Hollendoner Individual Corporate OfficerChief Executive Officer Jul 4, 2021
Jason Edward Patria Individual Corporate Director Jul 1, 2010
Tamika Butler Individual Corporate Director Jan 1, 2021
Katherine Duffy Individual W-2 Managing EmployeeChief Medical Officer Jan 1, 2024
Annie Nisa Imhoff Individual Corporate Director Feb 1, 2019
Luann Boylan Individual Corporate Director Jan 1, 1993
Donald Ray Thomas Individual Corporate Director Feb 1, 2019
Robyn L Goldman Individual Corporate OfficerChief Financial Officer Mar 18, 2024
Sarah Christina Dusseault Individual Corporate Director Feb 1, 2019
Susan Feniger Individual Corporate Director Jan 1, 2007
Carlos Medina Individual Corporate Director Jan 1, 2015
Lucinda Davis Moorhead Individual Corporate Director Feb 1, 2019
Frank Pond Individual Corporate Director Nov 1, 2012

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 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761177600000",
    "number": "1467057166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 SCHRADER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900286213",
            "telephone_number": "323-993-7605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2313 W MARTIN LUTHER KING JR BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900082724",
            "telephone_number": "323-860-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES LGBT CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOS ANGELES LGBT CENTER",
        "enumeration_date": "2020-12-01",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "323-993-8948"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Los Angeles LGBT Center - Center South",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Los Angeles LGBT Center - Center South",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.