Organization Active NPI

FC Comprehensive Healthcare a Professional Medical Corporation

Doing business as FC Comprehensive Healthcare

  • General Practice Physician
  • Compton, CA
National Provider Identifier
1861106908
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
FC COMPREHENSIVE HEALTHCARE A PROFESSIONAL MEDICAL CORPORATION
Doing business as
FC Comprehensive Healthcare
Practice address
1410 W Alondra Blvd
Compton, CA 90220-3533
Phone
(310) 933-8755
Fax
(310) 933-8738
NPI assigned
Jan 12, 2023
Last updated
Jun 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Authorized official

Name
Teodulo Bonzon, LCSWNPI 1497039192
Title
Cfo
Phone
(818) 846-4469

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1410 W Alondra Blvd
Compton, CA 90220-3533

Mailing address

4525 Eagle Rock Blvd
Los Angeles, CA 90041-3214
Phone (818) 846-4469

Other names 1

  • FC Comprehensive Healthcare Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "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"
        }
    ]
}

Other providers in Compton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.