NPIMap

Organization Active NPI

Operation Samahan, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
National Provider Identifier
1871680397
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
080000146 Issued in CA
Legal business name
OPERATION SAMAHAN, INC.
Practice address
10737 Camino Ruiz
Suite 235
San Diego, CA 92126-2359
Phone
(858) 578-4220
Fax
(858) 578-4417
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Authorized official

Name
Archie Bella, MDNPI 1487098497
Title
Ceo
Phone
(718) 986-9228

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 080000146 CA Primary

Addresses

Primary practice location

10737 Camino Ruiz
Suite 235
San Diego, CA 92126-2359

Mailing address

10737 Camino Ruiz
Suite 235
San Diego, CA 92126-2359
Phone (858) 578-4220

Other practice location 1

10737 Camino Ruiz Ste 140
San Diego, CA 92126-2371
Phone (844) 200-2426

Other identifiers 6

IdentifierTypeStateIssuer
EAP70250FOtherCAMEDICAID
W9341AOtherCAMEDICARE GROUP PROVIDER
EAP12036FOtherCAMEDICAID
ZZT12036FOtherCAMEDICAID
64OtherCACOUNTY MEDICAL SERVICES
FHC12036FOtherCAMEDICAID

Other names 1

  • Samahan Health Centers Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051001000054 CA Part B Supplier - Clinic/Group Practice 7911932645 Receives reassigned benefits from 42 practitioners
7 other NPIs on this enrollment
Practice locations: San Diego, CA; National City, CA
O20061017000589 CA Part A Provider - Federally Qualified Health Center (FQHC) 7911932645 Practice locations: San Diego, CA

Federally qualified health center certification: CCN 051061

Legal name
OPERATION SAMAHAN INC
Doing business as
OPERATION SAMAHAN OUTREACH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 3, 2006
Last certification
Nov 3, 2006
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 31, 2006 in CA
Enrollment address
10737 Camino Ruiz
Ste 235
San Diego, CA 92126-2375

Other NPIs with the same Medicare PAC ID 4

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.

National Provider Directory

National Provider Directory
Tax ID family
Operation Sama Han7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

2101 Granger Ave
Ste 101A
National City, CA 91950

2835 Highland Ave
National City, CA 91950
Phone (209) 683-5640

2835 Highland Ave
Ste B
National City, CA 91950

2101 Granger Ave
Ste 101
National City, CA 91950

5296 University Ave
Ste F1
San Diego, CA 92105
Phone (619) 229-6725

9995 Carmel Mountain Rd
Ste B10
San Diego, CA 92129

9995 Carmel Mountain Rd
#B10B11
San Diego, CA 92129

5296 University Ave
San Diego, CA 92105

9995 Carmel Mountain Rd
#B1011
San Diego, CA 92129

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Brandon Meza Individual Corporate Director Feb 17, 2017
Oscar Campos Individual Corporate Director Feb 17, 2017
Operation Samahan Inc Organization, National City, CA Corporation, Medical provider/supplier, Non-profit Operational/Managerial Control Nov 3, 2006 100%
Archie Bella Individual Corporate OfficerCeo Nov 21, 2021
W-2 Managing EmployeeCeo Nov 21, 2021
Alex Carolino Individual Corporate DirectorVice Chair Nov 27, 2019

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Operation Samahan ClinicNational City, CA, CCN 051060 Federally qualified health center Operational/Managerial Control (100%) Sep 20, 2006
Samahan Health CentersNational City, CA, CCN 751022 Federally qualified health center Other (100%) May 15, 1973
Operation Samahan IncSan Diego, CA, CCN A11035 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2025

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 55

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

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1871680397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10737 CAMINO RUIZ",
            "address_2": "SUITE 235",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262359",
            "telephone_number": "858-578-4220",
            "fax_number": "858-578-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10737 CAMINO RUIZ",
            "address_2": "SUITE 235",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262359",
            "telephone_number": "858-578-4220",
            "fax_number": "858-578-4417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10737 Camino Ruiz Ste 140",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921262371",
            "country_code": "US",
            "telephone_number": "844-200-2426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OPERATION SAMAHAN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "BELLA",
        "authorized_official_first_name": "ARCHIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-986-9228",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "080000146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "EAP70250F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PROVIDER",
            "identifier": "W9341A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "EAP12036F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "ZZT12036F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNTY MEDICAL SERVICES",
            "identifier": "64",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "FHC12036F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samahan Health Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.