NPIMap

Organization Active NPI

Central City Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Baldwin Park, CA
National Provider Identifier
1558770818
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
4160 Maine Ave Ste B1-B3
Baldwin Park, CA 91706-3304
Phone
(626) 384-2400
Fax
(626) 384-2403
NPI assigned
Aug 11, 2014
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 Reyes, DONPI 1619105327
Title
Ceo
Phone
(714) 490-2750

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

4160 Maine Ave Ste B1-B3
Baldwin Park, CA 91706-3304

Mailing address

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

Medicare participation

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

Enrollment records 2

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…
O20260119000340 CA Part A Provider - Federally Qualified Health Center (FQHC) 6608837331 Practice locations: Baldwin Park, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1558770818. Details of each certification follow.

Federally qualified health center certification: CCN A11037

Legal name
CENTRAL CITY COMMUNITY HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 21, 2026
Last certification
Jan 21, 2026
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
4160 N. Main Avenue
Ste B1-B3
Baldwin Park, CA 91706-3304

Other NPIs with the same Medicare PAC ID 10

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

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
05D2081416Central City Community4160 N Maine Ave Ste B1, B2,B3, Baldwin Park, CA 91706Certificate of waiverJul 23, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Juan Duran Individual Corporate DirectorBoard Treasurer Jan 1, 2010
Violeta Wang Individual Corporate DirectorBoard Member Jan 1, 2018
Rosemary David Reyes Individual Corporate OfficerChief Executive Officer Jun 1, 2021
W-2 Managing EmployeeCeo Jun 1, 2021
Melana Smith Individual Corporate DirectorBoard Member Jan 1, 2019
Larry Landless Individual Corporate DirectorBoard Secretary Jan 1, 2019
Dee Libertine Individual Corporate DirectorBoard Member Jan 1, 2019

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1558770818",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 MAINE AVE STE B1-B3",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063304",
            "telephone_number": "626-384-2400",
            "fax_number": "626-384-2403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CITY COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-11",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-490-2750",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "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 Baldwin Park, CA

Sources for this page

Verify at the official NPI Registry.