NPIMap

Organization Active NPI

Tri-State Community Healthcare Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
National Provider Identifier
1699303628
Registry record updated Mar 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
TRI-STATE COMMUNITY HEALTHCARE CENTER
Practice address
4137 Verdugo Rd
Los Angeles, CA 90065-3820
Phone
(323) 344-9255
Fax
(323) 344-8776
NPI assigned
Mar 27, 2020
Last updated
Mar 27, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
TRI-STATE COMMUNITY HEALTHCARE CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2020

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

Authorized official

Name
Aram Manoukian
Title
Ceo
Phone
(323) 297-0884

Specialties & licenses 1

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

Addresses

Primary practice location

4137 Verdugo Rd
Los Angeles, CA 90065-3820

Mailing address

4141 1/2 Verdugo Rd
Los Angeles, CA 90065-3820
Phone (323) 297-0884

Other names 1

  • Mobile Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
Tri-State Comm Hlthcare Ctr12 organizations share this tax ID, including this one
Part of
Tri-State Comm Hlthcare Ctr

Other organizations with this tax ID 11

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585267200000",
    "number": "1699303628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 1/2 VERDUGO RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900653820",
            "telephone_number": "323-297-0884",
            "fax_number": "323-274-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4137 VERDUGO RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900653820",
            "telephone_number": "323-344-9255",
            "fax_number": "323-344-8776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE COMMUNITY HEALTHCARE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRI-STATE COMMUNITY HEALTHCARE CENTER",
        "enumeration_date": "2020-03-27",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A",
        "authorized_official_last_name": "MANOUKIAN",
        "authorized_official_first_name": "ARAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-297-0884"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mobile Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.