South Bay Family Healthcare Center

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

SOUTH BAY FAMILY HEALTHCARE CENTER

Practice address

2114 Artesia Blvd
Redondo Beach, CA 90278-3014

Phone

(310) 802-6177

Fax

(310) 802-6178

NPI assigned

Feb 8, 2007

Last updated

Oct 5, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jann Hamiliton-Lee

Title

President-Ceo

Phone

(310) 802-6177

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Venice Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Redondo Beach, CA
  • NPI 1356914857

  Sold to, 2021-11-01

  CMS change of ownership

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.

• Rachna Kucheria, M.D.

  • Family Medicine Physician
  • Inglewood, CA
  • NPI 1154499655
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1548301229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23430 HAWTHORNE BLVD",
            "address_2": "BLDG 3, SUITE 210",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054720",
            "telephone_number": "310-802-6177",
            "fax_number": "310-802-6178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 ARTESIA BLVD",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783014",
            "telephone_number": "310-802-6177",
            "fax_number": "310-802-6178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY FAMILY HEALTHCARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "HAMILITON-LEE",
        "authorized_official_first_name": "JANN",
        "authorized_official_title_or_position": "PRESIDENT-CEO",
        "authorized_official_telephone_number": "310-802-6177"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70843F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMPACT",
            "identifier": "HAP70843F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EAPC",
            "identifier": "EAP70236F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary Soufl, DC
• South Bay Birth (South Bay Birth Birthing Center)
• South Bay Birth
• South Bay Children's Health Center
• South Bay Family Healthcare Center
• South Bay Nurse Anesthesia Services
• South Bay Podiatry Office Inc
• South Bay Regenerative Medical Spa Inc (Body Care Regenerative Medicine)
• Anna Southam, PT
• Southbay Galleria Optometric

• Federally Qualified Health Center (FQHC) in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Federally Qualified Health Center (FQHC) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.