FC Comprehensive Healthcare a Professional Medical Corporation

Key facts

NPI

1861106908

Entity type

Organization (NPI type 2)

Primary specialty

General Practice Physician 208D00000X

Legal business name

FC COMPREHENSIVE HEALTHCARE A PROFESSIONAL MEDICAL CORPORATION

Practice address

1410 W Alondra Blvd
Compton, CA 90220-3533

Phone

(310) 933-8755

Fax

(310) 933-8738

NPI assigned

Jan 12, 2023

Organization subpart

No

Authorized official

Name

Teodulo Bonzon, LCSW

Title

Cfo

Phone

(818) 846-4469

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• T.S.S Rajan, M.D Cardiovascular Disease Physician · Compton, CA · NPI 1396786653
  NPD
• Syed M Hossain, M.D. . Family Medicine Physician · Compton, CA · NPI 1083787907
  NPD (past)

National Provider Directory

Specialties & licenses

Addresses

Other names

• FC Comprehensive Healthcare Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 13, 2024.

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1861106908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 EAGLE ROCK BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900413214",
            "telephone_number": "818-846-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 W ALONDRA BLVD",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902203533",
            "telephone_number": "310-933-8755",
            "fax_number": "310-933-8738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FC COMPREHENSIVE HEALTHCARE A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-12",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "BONZON",
        "authorized_official_first_name": "TEODULO",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "818-846-4469",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FC Comprehensive Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FC Comprehensive Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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