NPIMap

Organization Active NPI

Central City Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Garden Grove, CA
National Provider Identifier
1588972129
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
12511 Brookhurst St
Garden Grove, CA 92840
Phone
(714) 643-7176
Fax
(714) 643-7180
NPI assigned
Sep 16, 2010
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, DO
Title
Ceo
Phone
(714) 490-2750

Specialties & licenses 1

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

Addresses

Primary practice location

12511 Brookhurst St
Garden Grove, CA 92840

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1235283094MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120827000765 CA Part A Provider - Federally Qualified Health Center (FQHC) 6608837331 Practice locations: Garden Grove, CA

Federally qualified health center certification: CCN 551187

Legal name
CENTRAL CITY COMMUNITY HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 27, 2012
Last certification
Aug 27, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 26, 1994 in CA
Enrollment address
12511 Brookhurst St
FL 2
Garden Grove, CA 92840-4806

Other NPIs with the same Medicare PAC ID 10

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

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
05D0707692Central City Community12511 Brookhurst St, Garden Grove, CA 92840Certificate of waiverDec 12, 2026

National Provider Directory

National Provider Directory
Tax ID family
Central City Community Health Center14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

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

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)…

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Rosemary David Reyes Individual Corporate OfficerChief Executive Officer Jun 1, 2021 100%
W-2 Managing EmployeeChief Executive Officer Jun 1, 2021 100%
Patricia Torres Individual W-2 Managing EmployeeExecutive Assistant Dec 14, 2021

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1588972129",
    "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": "12511 BROOKHURST ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "92840",
            "telephone_number": "714-643-7176",
            "fax_number": "714-643-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CITY COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-16",
        "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": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235283094",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.