NPIMap

Organization Active NPI

Celebrating Life Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Costa Mesa, CA
National Provider Identifier
1699520809
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CELEBRATING LIFE COMMUNITY HEALTH CENTER
Practice address
700 W 19TH St
Costa Mesa, CA 92627-3517
Phone
(949) 866-3600
NPI assigned
Apr 22, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Authorized official

Name
Sergey P Sergeyev, MPA
Title
Ceo
Phone
(949) 866-3600

Specialties & licenses 1

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

Addresses

Primary practice location

700 W 19TH St
Costa Mesa, CA 92627-3517

Mailing address

27271 Las Ramblas Ste 350
Mission Viejo, CA 92691-8004
Phone (949) 866-3600

National Provider Directory

National Provider Directory
Tax ID family
Celebrating Life Community Health Center9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1699520809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27271 LAS RAMBLAS STE 350",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918004",
            "telephone_number": "949-866-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W 19TH ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273517",
            "telephone_number": "949-866-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CELEBRATING LIFE COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-21",
        "status": "A",
        "authorized_official_last_name": "SERGEYEV",
        "authorized_official_first_name": "SERGEY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-866-3600",
        "authorized_official_credential": "MPA"
    },
    "taxonomies": [
        {
            "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 Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.