NPIMap

Organization Active NPI

East Valley Community Health Center

  • Community Health Clinic/Center
  • Pomona, CA
National Provider Identifier
1669588893
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
EAST VALLEY COMMUNITY HEALTH CENTER
Practice address
680 Fairplex Dr
Pomona, CA 91768-1100
Phone
(909) 620-8088
Fax
(626) 919-8503
NPI assigned
Aug 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Alicia Mardini
Title
Chief Executive Officer
Phone
(626) 919-4333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X CA Primary

Addresses

Primary practice location

680 Fairplex Dr
Pomona, CA 91768-1100

Mailing address

420 S Glendora Ave
West Covina, CA 91790-3001
Phone (626) 919-4333

National Provider Directory

National Provider Directory

Locations

680 Fairplex Dr
Pomona, CA 91768
Phone (909) 620-8088

Practitioners & affiliated clinicians

Practitioners 5

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": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669588893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S GLENDORA AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903001",
            "telephone_number": "626-919-4333",
            "fax_number": "626-919-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 FAIRPLEX DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917681100",
            "telephone_number": "909-620-8088",
            "fax_number": "626-919-8503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST VALLEY COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARDINI",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "626-919-4333"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.