NPIMap

Organization Active NPI

All-Inclusive Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Northridge, CA
National Provider Identifier
1982179008
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ALL-INCLUSIVE COMMUNITY HEALTH CENTER
Practice address
17114 Devonshire St Ste 200
Northridge, CA 91325-1619
Phone
(818) 646-1771
Fax
(818) 855-2335
NPI assigned
Oct 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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

Authorized official

Name
Marine Dzhgalyan
Title
Ceo
Phone
(818) 843-9900

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

17114 Devonshire St Ste 200
Northridge, CA 91325-1619

Mailing address

1311 N San Fernando Blvd
Burbank, CA 91504-4236
Phone (818) 843-9900

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110906000533 CA Part B Supplier - Clinic/Group Practice 5294905006 Receives reassigned benefits from 16 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Burbank, CA; Los Angeles, CA; Northridge, CA
O20200519002754 CA Part A Provider - Federally Qualified Health Center (FQHC) 5294905006 Practice locations: Northridge, CA

Federally qualified health center certification: CCN 921887

Legal name
ALL-INCLUSIVE COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 14, 2020
Last certification
May 14, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 23, 2010 in CA
Enrollment address
17114 Devonshire St
Ste 200
Northridge, CA 91325-1619

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Locations

17114 Devonshire St
Ste 200
Northridge, CA 91325
Phone (818) 646-1771

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
Maria Castaneda Individual Corporate Director Jun 23, 2014
Marine Dzhgalyan Individual Corporate OfficerCeo Aug 27, 2012 100%
W-2 Managing Employee Aug 27, 2012
Giovanni Rodriguez Individual Corporate Director Jun 23, 2014
Aida Peralta Individual Corporate Director Jun 10, 2011
Araik Gukasyan Individual Corporate Director Jan 3, 2011
Mariam Kuregyan Individual Corporate Director Jun 10, 2011
All-Inclusive Community Health Center Organization, Northridge, CA Corporation 5% Or Greater Direct Ownership Interest Jan 1, 2019
Kristina Atalaryan Individual Corporate Director Aug 28, 2014
Jannett Garibian Individual Corporate Director Jan 7, 2011
Parantzem Hairapetian Individual Corporate Director Jan 7, 2011
Marlene Sanchez Individual Corporate Director Sep 1, 2015

Owners & managing parties with NPI records 2

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
All-Inclusive Community Health CenterBurbank, CA, CCN 751015 Federally qualified health center Operational/Managerial Control Dec 18, 2012
All-Inclusive Community Health CenterLos Angeles, CA, CCN 751834 Federally qualified health center 5% Or Greater Security Interest (100%) Dec 1, 2015

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542240000000",
    "number": "1982179008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 N SAN FERNANDO BLVD",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915044236",
            "telephone_number": "818-843-9900",
            "fax_number": "818-843-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17114 DEVONSHIRE ST STE 200",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913251619",
            "telephone_number": "818-646-1771",
            "fax_number": "818-855-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL-INCLUSIVE COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-04",
        "last_updated": "2018-11-15",
        "status": "A",
        "authorized_official_last_name": "DZHGALYAN",
        "authorized_official_first_name": "MARINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-843-9900"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.