NPIMap

Organization Active NPI

Comprehensive Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Sunland, CA
National Provider Identifier
1972954071
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMPREHENSIVE COMMUNITY HEALTH CENTERS, INC.
Practice address
8316 Foothill Blvd
Sunland, CA 91040-2850
Phone
(818) 630-6106
Fax
(818) 630-7925
NPI assigned
Jun 29, 2016
Last updated
Feb 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Authorized official

Name
Flora Poladyan
Title
Coo
Phone
(818) 630-6106

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

8316 Foothill Blvd
Sunland, CA 91040-2850

Mailing address

801 S Chevy Chase Dr
20
Glendale, CA 91205-4431
Phone (818) 630-6130

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031107000548 CA Part B Supplier - Clinic/Group Practice 9638082456 Receives reassigned benefits from 66 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arleta, CA; Glendale, CA; Los Angeles, CA; N Hollywood, CA; Sunland, CA
O20170426000571 CA Part A Provider - Federally Qualified Health Center (FQHC) 9638082456 Practice locations: Sunland, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972954071. Details of each certification follow.

Federally qualified health center certification: CCN 751961

Legal name
COMPREHENSIVE COMMUNITY HEALTH CENTERS INC
Doing business as
COMPREHENSIVE COMMUNITY HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 27, 2017
Last certification
Feb 27, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 13, 2002 in CA
Enrollment address
8316 Foothill Blvd
Sunland, CA 91040-2850

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Jean-Pierre E Antaki Individual Corporate DirectorMember of Board of Directors Sep 14, 2009
Jennifer L Smith Individual Corporate OfficerChief Administrative Officer Jan 24, 2022
David G Lontok Individual Corporate OfficerCeo Mar 1, 2018
W-2 Managing EmployeeCeo May 4, 2020
Odet Mkrtchian Individual Corporate DirectorMember of Board of Directors Jan 15, 2018
Armen Der Abrahamian Individual Corporate DirectorMember of Board of Directors Mar 13, 2017
Genesis Nungaray Individual Corporate DirectorBoard Member Oct 11, 2021
Nancy Guillen Individual Corporate DirectorMember of Board of Directors Nov 11, 2013
Ara Tavitian Individual Corporate DirectorMember of Board of Directors Mar 12, 2018
Flora Poladyan Individual Corporate OfficerChief Operations Officer Oct 24, 2002
Rika Okazaki Individual Corporate DirectorBoard Member Aug 9, 2021
Greg Krikorian Individual Corporate DirectorMember of Board of Directors Apr 22, 2013

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 12

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": "1467158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1972954071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S CHEVY CHASE DR",
            "address_2": "20",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054431",
            "telephone_number": "818-630-6130",
            "fax_number": "818-630-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8316 FOOTHILL BLVD",
            "city": "SUNLAND",
            "state": "CA",
            "postal_code": "910402850",
            "telephone_number": "818-630-6106",
            "fax_number": "818-630-7925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE COMMUNITY HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-29",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "POLADYAN",
        "authorized_official_first_name": "FLORA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "818-630-6106"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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 Sunland, CA

Sources for this page

Verify at the official NPI Registry.