NPIMap

Organization Active NPI

Central City Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Indio, CA
National Provider Identifier
1508254814
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CENTRAL CITY COMMUNITY HEALTH CENTER INC
Practice address
81709 Dr Carreon Blvd Ste E1
Indio, CA 92201-5589
Phone
(760) 342-3336
Fax
(866) 997-9757
NPI assigned
Jan 8, 2015
Last updated
Dec 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Authorized official

Name
Rosemary D Reyes, DO
Title
Ceo
Phone
(323) 724-0019

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
General Practice Physician 208D00000X

Addresses

Primary practice location

81709 Dr Carreon Blvd Ste E1
Indio, CA 92201-5589

Mailing address

2019 Saturn St
Monterey Park, CA 91755-7415
Phone (323) 724-0019

Other practice location 1

81709 Dr Carreon Blvd Ste E2
Indio, CA 92201-5589
Phone (760) 342-3336

Other identifiers 1

IdentifierTypeStateIssuer
1033488416MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041025001177 CA Part B Supplier - Clinic/Group Practice 6608837331 Receives reassigned benefits from 105 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: El Monte, CA; Upland, CA; Stanton, CA; Norco, CA; Los Angeles, CA; La Puente, CA; Indio, CA; Garden Grove, CA…

Other NPIs on the same Medicare enrollment 13

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

View all 13

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
05D0885390Central City Community81709 Dr Carreon Blvd, Ste E-2, Indio, CA 92201Certificate of waiverApr 19, 2028

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 8

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": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1508254814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 SATURN ST",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917557415",
            "telephone_number": "323-724-0019",
            "fax_number": "323-248-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81709 DR CARREON BLVD STE E1",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015589",
            "telephone_number": "760-342-3336",
            "fax_number": "866-997-9757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "81709 Dr Carreon Blvd Ste E2",
            "address_purpose": "LOCATION",
            "city": "Indio",
            "state": "CA",
            "postal_code": "922015589",
            "country_code": "US",
            "telephone_number": "760-342-3336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRAL CITY COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-724-0019",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033488416",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.