NPIMap

Organization Active NPI

South Central Family Health Center

Doing business as Montebello Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Montebello, CA
National Provider Identifier
1851982797
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SOUTH CENTRAL FAMILY HEALTH CENTER
Doing business as
Montebello Family Health Center
Practice address
2417 W Whittier Blvd
Montebello, CA 90640-3040
Phone
(323) 908-4200
NPI assigned
Feb 2, 2021
Last updated
Feb 2, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH CENTRAL FAMILY HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Authorized official

Name
Mr. Richard A Veloz, JD
Title
Ceo
Phone
(323) 908-4237

Specialties & licenses 1

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

Addresses

Primary practice location

2417 W Whittier Blvd
Montebello, CA 90640-3040

Mailing address

1111 E Vernon Ave
Los Angeles, CA 90011-3718
Phone (323) 908-4200

Other names 1

  • Montebello Family Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210319000469 CA Part A Provider - Federally Qualified Health Center (FQHC) 5597675041 Practice locations: Montebello, CA
O20240621003215 CA Part B Supplier - Clinic/Group Practice 5597675041 Receives reassigned benefits from 35 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Huntington Park, CA; Cudahy, CA; Montebello, CA; Los Angeles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851982797. Details of each certification follow.

Federally qualified health center certification: CCN 921964

Legal name
SOUTH CENTRAL FAMILY HEALTH CENTER
Doing business as
MONTEBELLO FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 11, 2021
Last certification
Mar 11, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 15, 1983 in CA
Enrollment address
2417 W Whittier Blvd
Montebello, CA 90640-3040

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
05D2268172Montebello Family Health Center2417 W. Whittier Blvd., Montebello, CA 90640Provider-performed microscopySep 6, 2026

National Provider Directory

National Provider Directory
Part of
South Central Fam HLTH

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Elmer G Roldan Individual Corporate DirectorBoard Member Jun 29, 2016
Victoria Hardy Individual Corporate DirectorTreasurer Apr 20, 2018
Ian Wright Individual Corporate DirectorSecretary Sep 17, 2019
Jose L Perez Individual Corporate OfficerChief Medial Officer Mar 16, 2017
Richard a Veloz Individual Corporate OfficerChief Executive Officer Jul 8, 2002
W-2 Managing EmployeeChief Executive Officer Jul 8, 2002
Adrian Devargas Individual Corporate DirectorVice-Chair Oct 13, 2016
Davis G Montalvan Individual Corporate DirectorBoard Member Mar 19, 2019
Genevieve Filmardirossian Individual Corporate OfficerChief Operations Officer Oct 16, 2006
Paul Ramos Individual Corporate OfficerChief Financial Officer Aug 6, 2002
W-2 Managing EmployeeChief Financial Officer Aug 6, 2002
Janice R Brittain Individual Corporate DirectorBoard Member May 27, 2008
Fernando Almodovar Individual Corporate DirectorBoard Chair Apr 26, 2011
Tumani S Moore-Leatherwood Individual Corporate DirectorBoard Member Dec 16, 2008
Resa a Caivano Individual Corporate DirectorBoard Member Nov 7, 2018
Rosie Rios Individual Corporate DirectorBoard Member May 27, 2008
Amir a Johnson Individual Corporate DirectorBoard Member Nov 4, 2014

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
South Central Family Health Center-VernonLos Angeles, CA, CCN 921013 Federally qualified health center Operational/Managerial Control Jul 31, 2012
Cudahy Family Health CenterCudahy, CA, CCN 921079 Federally qualified health center Operational/Managerial Control (100%) Nov 1, 2016

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1612224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612224000000",
    "number": "1851982797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E VERNON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900113718",
            "telephone_number": "323-908-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2417 W WHITTIER BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906403040",
            "telephone_number": "323-908-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL FAMILY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH CENTRAL FAMILY HEALTH CENTER",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A",
        "authorized_official_last_name": "VELOZ",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-908-4237",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "JD"
    },
    "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": "Montebello Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montebello, CA

Sources for this page

Verify at the official NPI Registry.