30
Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated CENTRAL CITY COMMUNITY HEALTH CENTER INC 1235283094 5970 S CENTRAL AVE LOS ANGELES 90001-1150 (323) 234-3280 22 4 6 3 8/1/2003 SGHIATTI, VINCENT R APC 1750469318 6316 HOLMES AVE LOS ANGELES 90001-1824 (323) 583-5887 13 4 6 3 4/20/2004 CHEN, LULU L MD INC 1649426990 1318 E FLORENCE AVE LOS ANGELES 90001-1935 (323) 584-9525 12 4 6 3 9/29/2010 ADVANCED FAMILY CARE MEDICAL GROUP 1033267216 1201 E FLORENCE AVE LOS ANGELES 90001-2432 (323) 588-0084 12 4 6 3 12/3/1998 CROWN CITY MEDICAL GROUP INC 1962525964 1542 E FLORENCE AVE LOS ANGELES 90001-2536 (323) 584-0222 12 4 6 3 1/27/2005 FLORENCE MEDICAL CTR INC 1013932979 1557 E FLORENCE AVE LOS ANGELES 90001-2597 (323) 584-1490 12 4 6 3 2/18/1999 ANGEL FAMILY PRACTICE MEDICAL GROUP INC 1134206436 2015 E FLORENCE AVE LOS ANGELES 90001-2754 (323) 581-0000 13 4 6 3 5/16/1994 WATTS HEALTHCARE CORPORATION 1376681486 10110 JUNIPER ST LOS ANGELES 90002-3166 (323) 488-5915 22 4 6 3 4/1/2003 WATTS HEALTHCARE CORPORATION 1477649119A 10300 COMPTON AVE LOS ANGELES 90002-3628 (323) 564-4331 22 4 6 3 7/28/2003 CO OF L.A. - HUMPHREY COMPREHENSIVE HC 1982611919 5850 S MAIN ST LOS ANGELES 90003-1215 (323) 897-6300 22 4 6 3 12/31/2006 UNIVERSITY MUSLIM MEDICAL ASSOCIATION INC 1730421330 7821 AVALON BLVD LOS ANGELES 90003-2358 (323) 789-5610 22 4 6 3 8/19/2014 SANTIAGO-SORIANO, SUSANA V MD INC 1336296565 3908 BEVERLY BLVD LOS ANGELES 90004-3407 (213) 388-2508 13 4 4 3 8/5/2002 TERESA MEDICAL CENTER INC. 1205056033B 326 N VERMONT AVE LOS ANGELES 90004-4415 (323) 660-5900 12 4 4 3 8/5/2009 TAN, TERESITA E MD 1396835633 244 S OXFORD AVE STE 9 LOS ANGELES 90004-5126 (213) 382-1770 13 4 4 3 10/5/1984 QUEENSCARE HEALTH CENTERS 1093886251 184 S BIMINI PLACE LOS ANGELES 90004-5903 (213) 201-6878 22 4 4 3 4/9/2008 MUNGCAL, RENATO V MD 1003886847 133 S. VERMONT AVENUE LOS ANGELES 90004-5904 (213) 480-0748 13 4 4 3 1/4/1993 CHOW MEDICAL CLINIC INC 1053771394 817 S VERMONT AVE LOS ANGELES 90005-1522 213-385-0029 12 4 4 3 1/11/2017 ARDMORE MED GROUP INC 1124189212 3518 W 8TH ST LOS ANGELES 90005-2902 (213) 384-9949 12 4 4 3 5/27/1993 CENTURY WOMEN MEDICAL GROUP INC 1285753723 2030 W PICO BLVD LOS ANGELES 90006-0000 (213) 389-4544 12 4 4 3 5/20/2008 YI, DONG J MD 1023176229 1058 S VERMONT AVE STE 227 LOS ANGELES 90006-2731 (213) 368-6025 13 4 4 3 8/22/1996 LEE, MI- JEONG MD 1568481471 2675 W OLYMPIC BLVD STE 103 LOS ANGELES 90006-2880 (213) 252-0036 13 4 4 3 8/6/2001 ALFRED LAVI, DO PROFESSIONAL CORPORATION 1629198791A 2324 W PICO BLVD LOS ANGELES 90006-4002 (213) 383-3600 12 4 4 3 3/24/2005 ST ANTHONY MEDICAL CTR PICO CLINIC 1952451031 2515 W PICO BLVD LOS ANGELES 90006-4003 (213) 384-4555 22 4 4 3 8/20/2012 L AND P MEDICAL GROUP INC 1710077961 1107 S ALVARADO ST STE 102 LOS ANGELES 90006-4161 (213) 380-9999 13 4 4 3 11/13/2000 LEE, SEUNG M MEDICAL INC 1962665349 2030 W PICO BLVD STE 1 LOS ANGELES 90006-5011 (213) 427-0667 13 4 6 3 8/22/2005 HONG, SUNG J MD 1235155151 3000 W OLYMPIC BLVD., STE 304 LOS ANGELES 90006-6513 (323) 733-1122 13 4 4 3 10/3/1980 ST JOHN'S WELL CHILD CTR 1073653630 1910 SOUTH MAGNOLIA AVE LOS ANGELES 90007-1220 (213) 749-0947 22 4 6 3 2/14/2002 Monday, March 23, 2020 Page 1 of 30 County of Los Angeles - Department of Public Health Child Health And Disability Prevention Program Active Providers

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Page 1: County of Los Angeles - Department of Public Health Child ...publichealth.lacounty.gov/cms/docs/CHDPProviderRosterByZip.pdfmungcal, renato v md 1003886847 133 s. vermont avenue los

Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

CENTRAL CITY COMMUNITY HEALTH CENTER INC

1235283094 5970 S CENTRAL AVE LOS ANGELES 90001-1150 (323) 234-3280 22 4 6 3 8/1/2003

SGHIATTI, VINCENT R APC 1750469318 6316 HOLMES AVE LOS ANGELES 90001-1824 (323) 583-5887 13 4 6 3 4/20/2004

CHEN, LULU L MD INC 1649426990 1318 E FLORENCE AVE LOS ANGELES 90001-1935 (323) 584-9525 12 4 6 3 9/29/2010

ADVANCED FAMILY CARE MEDICAL GROUP 1033267216 1201 E FLORENCE AVE LOS ANGELES 90001-2432 (323) 588-0084 12 4 6 3 12/3/1998

CROWN CITY MEDICAL GROUP INC 1962525964 1542 E FLORENCE AVE LOS ANGELES 90001-2536 (323) 584-0222 12 4 6 3 1/27/2005

FLORENCE MEDICAL CTR INC 1013932979 1557 E FLORENCE AVE LOS ANGELES 90001-2597 (323) 584-1490 12 4 6 3 2/18/1999

ANGEL FAMILY PRACTICE MEDICAL GROUP INC 1134206436 2015 E FLORENCE AVE LOS ANGELES 90001-2754 (323) 581-0000 13 4 6 3 5/16/1994

WATTS HEALTHCARE CORPORATION 1376681486 10110 JUNIPER ST LOS ANGELES 90002-3166 (323) 488-5915 22 4 6 3 4/1/2003

WATTS HEALTHCARE CORPORATION 1477649119A 10300 COMPTON AVE LOS ANGELES 90002-3628 (323) 564-4331 22 4 6 3 7/28/2003

CO OF L.A. - HUMPHREY COMPREHENSIVE HC 1982611919 5850 S MAIN ST LOS ANGELES 90003-1215 (323) 897-6300 22 4 6 3 12/31/2006

UNIVERSITY MUSLIM MEDICAL ASSOCIATION INC

1730421330 7821 AVALON BLVD LOS ANGELES 90003-2358 (323) 789-5610 22 4 6 3 8/19/2014

SANTIAGO-SORIANO, SUSANA V MD INC 1336296565 3908 BEVERLY BLVD LOS ANGELES 90004-3407 (213) 388-2508 13 4 4 3 8/5/2002

TERESA MEDICAL CENTER INC. 1205056033B 326 N VERMONT AVE LOS ANGELES 90004-4415 (323) 660-5900 12 4 4 3 8/5/2009

TAN, TERESITA E MD 1396835633 244 S OXFORD AVE STE 9 LOS ANGELES 90004-5126 (213) 382-1770 13 4 4 3 10/5/1984

QUEENSCARE HEALTH CENTERS 1093886251 184 S BIMINI PLACE LOS ANGELES 90004-5903 (213) 201-6878 22 4 4 3 4/9/2008

MUNGCAL, RENATO V MD 1003886847 133 S. VERMONT AVENUE LOS ANGELES 90004-5904 (213) 480-0748 13 4 4 3 1/4/1993

CHOW MEDICAL CLINIC INC 1053771394 817 S VERMONT AVE LOS ANGELES 90005-1522 213-385-0029 12 4 4 3 1/11/2017

ARDMORE MED GROUP INC 1124189212 3518 W 8TH ST LOS ANGELES 90005-2902 (213) 384-9949 12 4 4 3 5/27/1993

CENTURY WOMEN MEDICAL GROUP INC 1285753723 2030 W PICO BLVD LOS ANGELES 90006-0000 (213) 389-4544 12 4 4 3 5/20/2008

YI, DONG J MD 1023176229 1058 S VERMONT AVE STE 227 LOS ANGELES 90006-2731 (213) 368-6025 13 4 4 3 8/22/1996

LEE, MI- JEONG MD 1568481471 2675 W OLYMPIC BLVD STE 103 LOS ANGELES 90006-2880 (213) 252-0036 13 4 4 3 8/6/2001

ALFRED LAVI, DO PROFESSIONAL CORPORATION

1629198791A 2324 W PICO BLVD LOS ANGELES 90006-4002 (213) 383-3600 12 4 4 3 3/24/2005

ST ANTHONY MEDICAL CTR PICO CLINIC 1952451031 2515 W PICO BLVD LOS ANGELES 90006-4003 (213) 384-4555 22 4 4 3 8/20/2012

L AND P MEDICAL GROUP INC 1710077961 1107 S ALVARADO ST STE 102 LOS ANGELES 90006-4161 (213) 380-9999 13 4 4 3 11/13/2000

LEE, SEUNG M MEDICAL INC 1962665349 2030 W PICO BLVD STE 1 LOS ANGELES 90006-5011 (213) 427-0667 13 4 6 3 8/22/2005

HONG, SUNG J MD 1235155151 3000 W OLYMPIC BLVD., STE 304 LOS ANGELES 90006-6513 (323) 733-1122 13 4 4 3 10/3/1980

ST JOHN'S WELL CHILD CTR 1073653630 1910 SOUTH MAGNOLIA AVE LOS ANGELES 90007-1220 (213) 749-0947 22 4 6 3 2/14/2002

Monday, March 23, 2020 Page 1 of 30

County of Los Angeles - Department of Public HealthChild Health And Disability Prevention Program

Active Providers

Page 2: County of Los Angeles - Department of Public Health Child ...publichealth.lacounty.gov/cms/docs/CHDPProviderRosterByZip.pdfmungcal, renato v md 1003886847 133 s. vermont avenue los

Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

AKHAVAN, AFSHIN DO A PROFESSIONAL CORPORATION

1821210329A 2409 S VERMONT AVE LOS ANGELES 90007-1661 (323) 730-1663 12 4 4 3 9/20/2005

CENTRAL NEIGHBORHOOD HEALTH FOUNDATION

1487086989 2614 S GRAND AVENUE LOS ANGELES 90007-2607 (323) 234-5000 22 4 6 3 8/1/2017

ST JOHNS WELL CHILD AND FAMILY CENTER INC

1861893844 326 W 23RD STREET LOS ANGELES 90007-2659 (213) 741-0638 22 4 6 3 2/10/2016

CO OF L.A. - HUDSON COMPREHENSIVE HLTH 1144233800 2829 S GRAND AVE LOS ANGELES 90007-3304 (213) 744-6312 22 4 6 3 12/31/2006

CRENSHAW HEALTHCARE CORPORATION 1225177751 3756 SANTA ROSALIA DR SUITE 400

LOS ANGELES 90008-3614 (323) 568-5460 22 4 6 3 10/8/2003

BALDWIN HILLS PEDIATRICS 1679019202 3756 SANTA ROSALIA DR STE 320 LOS ANGELES 90008-3615 (323) 292-5600 13 4 6 3 9/24/2008

AZINGE-OBASI, MEZIA O MD DOCTOR PAUL MEMORIAL MED

1659379634 3450 W 43RD ST STE 106 LOS ANGELES 90008-4944 (323) 290-2832 13 4 6 3 3/11/2010

COVINGTON, ELIZABETH MD A PROFESSIONAL CORP

1346350386 3701 STOCKER ST STE 101 LOS ANGELES 90008-5145 (323) 290-2107 13 4 6 3 9/10/1996

NEJAT ROSTAMI MEDICAL GROUP INC 1609913441 2972 WILSHIRE BLVD LOS ANGELES 90010-1101 (213) 484-0000 12 4 4 3 3/5/1993

KOREAN HEALTH EDUCATION INFORMATION AND RESEARCH

1013311448 3255 WILSHIRE BLVD STE 120 LOS ANGELES 90010-1405 213-235-2500 22 4 4 3 12/7/2016

GHALILI, SAMAN MD 1891724993 2101 S SAN PEDRO ST LOS ANGELES 90011-1125 (213) 745-8766 12 4 6 3 10/29/2007

S AND S MEDICAL GROUP INC 1548458987 648 E. 21ST ST LOS ANGELES 90011-1146 213-749-7110 13 4 6 3 9/13/2000

UNIVERSAL COMMUNITY HEALTH 1174913776 2801 SOUTH SAN PEDRO ST LOS ANGELES 90011-2023 (323) 233-3100 22 4 6 3 11/2/2016

SOUTH CENTRAL FAMILY HEALTH CENTER 1588908305 3410 S HOOPER AVE LOS ANGELES 90011-2161 (323) 908-4200 22 4 6 3 12/22/2014

SOUTH CENTRAL FAMILY HEALTH CTR 1396891909 4425 S CENTRAL AVE LOS ANGELES 90011-3629 (323) 908-4200 22 4 6 3 12/1/1994

CLINICA DEL SOCORRO MEDICAL GROUP INC 1215263827 1061 E VERNON AVE STE F LOS ANGELES 90011-3772 (323) 233-9686 12 4 6 3 12/6/2011

CENTRAL NEIGHBORHOOD HEALTH FOUNDATION

1639336803 2707 S CENTRAL AVE LOS ANGELES 90011-5527 (323) 234-5000 22 4 6 3 4/7/1980

KEDREN COMMUNITY HEALTH CENTER INC 1417378597 4211 SOUTH AVALON BLVD SUITE A LOS ANGELES 90011-5622 323-234-0616 22 4 6 3 2/27/2015

GANATA JR, JOSE R MD 1730107293 625 W COLLEGE ST STE 105 LOS ANGELES 90012-1650 (213) 617-9157 13 4 4 3 10/1/1983

ALTAMED MEDICAL AND DENTAL -WILLIAMS MEAD

1255542601B 268 E BLOOM STREET STE 322 LOS ANGELES 90012-1973 323-276-0267 22 4 4 3 12/19/2007

CHINATOWN SERVICE CENTER FAMILY HEALTH CLINIC

1427046754 767 N HILL ST., STE 200 LOS ANGELES 90012-2365 (213) 808-1792 22 4 4 3 1/5/2006

TON, HOANG TICH MD 1750480158 642 N BROADWAY STE 2 LOS ANGELES 90012-2838 (213) 620-1720 13 4 4 3 9/22/1983

TRAN, KIET T MD 1285636209 815 W CESAR E CHAVEZ AVE STE 201

LOS ANGELES 90012-6601 (213) 617-8246 13 4 4 3 9/6/1990

Monday, March 23, 2020 Page 2 of 30

County of Los Angeles - Department of Public HealthChild Health And Disability Prevention Program

Active Providers

Page 3: County of Los Angeles - Department of Public Health Child ...publichealth.lacounty.gov/cms/docs/CHDPProviderRosterByZip.pdfmungcal, renato v md 1003886847 133 s. vermont avenue los

Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

NGUYEN, THANG P MD 1477730166 1271 S UNION AVE LOS ANGELES 90015-2043 213-386-0214 13 4 4 3 4/1/2003

PICO CLINICA MEDICA LATINA MED GRP INC 1740329101 1600 W PICO BLVD LOS ANGELES 90015-2410 (213) 386-5252 12 4 4 3 1/8/1999

STEINBERG, DAVID MD INC 1730300617 1513 S GRAND AVE STE 320 LOS ANGELES 90015-3021 213-747-7307 13 4 4 3 9/11/2008

EISNER PEDIATRIC AND FAMILY MEDICAL CENTER

1316044522 1530 S OLIVE ST LOS ANGELES 90015-3023 (213) 747-5542 22 4 4 3 12/1/2002

PEDIATRIC AND FAMILY MEDICAL CENTER 1386934875 1400 SOUTH GRAND AVE STE 101 LOS ANGELES 90015-3023 (213) 744-0801 22 4 4 3 1/21/2010

NORTHEAST COMMUNITY CLINIC 1982938213 1400 S GRAND AVE STE 700 LOS ANGELES 90015-3068 (213) 765-7500 22 4 4 3 1/5/2011

NORTHEAST COMMUNITY CLINICS INTERMITTENT

1124460274STA

1414 S GRAND AVE STE 380 LOS ANGELES 90015-3075 (213) 222-1300 22 4 4 3 10/6/2016

AKHAVAN, AFSHIN DO A 1821210329B 530 E WASHINGTON BLVD LOS ANGELES 90015-3723 (213) 747-2626 12 4 4 3 7/21/2011

T.H.E. CLINIC, INC 1023287679STB

3721 LA BREA AVENUE LOS ANGELES 90016 (323) 730-1920 22 4 6 3 4/7/2016

BENEVOLENCE INDUSTRIES INC 1578763207 3631 CRENSHAW BLVD SUITE 109 LOS ANGELES 90016-4869 323-732-0100 22 4 6 3 12/31/2012

BEESLEY, ELLIS N JR MD 1063470219 1127 WILSHIRE BLVD STE 707 LOS ANGELES 90017-3908 (213) 482-4830 13 4 4 3 11/20/1992

LALEZARI, BAHMAN MD INC 1205137452 4944 W PICO BLVD LOS ANGELES 90019-4228 (323) 939-5346 13 4 4 3 8/29/1997

BENEVOLENCE INDUSTRIES INC 1376761940 3533 W. PICO BLVD LOS ANGELES 90019-4534 (323) 734-1600 22 4 4 3 12/6/2010

KIM, JANET S MD INC 1265764955 500 S VIRGIL AVE STE 204 LOS ANGELES 90020-1404 (213) 388-7828 13 4 4 3 10/5/2010

CHANG, BONG S MD 1427131150 3671 W 6TH ST LOS ANGELES 90020-3026 (213) 383-8496 13 4 4 3 6/10/1983

M PAKOUR MD INC 1275030009 3671 W 6TH ST STE B LOS ANGELES 90020-3026 (213) 375-7511 13 4 4 3 12/7/2018

ABC PEDIATRICS INC 1336305267 3663 W 6TH ST STE 301 LOS ANGELES 90020-3050 (213) 291-3228 13 4 4 3 11/4/2010

KOREAN HEALTH EDUCATION KHEIR HEALTH SVS CTR

1437377454 3727 W 6TH ST STE 200 LOS ANGELES 90020-5108 (213) 235-2500 22 4 4 3 10/19/2006

UNIVERSAL COMMUNITY HEALTH CENTER 1093023277 1005 E WASHINGTON BLVD STE A LOS ANGELES 90021-3020 (323) 233-3100 22 4 4 3 9/9/2004

VIA CARE COMMUNITY HEALTH CENTER 1770034530 607 S ATLANTIC BLVD LOS ANGELES 90022 (323) 268-9191 25 4 7 2 7/16/2018

VIA CARE COMMUNITY HEALTH CENTER INC. 1497001226STA

501 S WOODS AVE LOS ANGELES 90022 323-268-9191 22 4 7 2 6/22/2016

VIA CARE COMMUNITY HEALTH CENTER, INC 1497001226STB

5015 WHITTIER BLVD LOS ANGELES 90022 323-981-2930 22 4 7 2 1/5/2017

VIA CARE COMMUNITY HEALTH CETER INC 1497001226STC

4755 E CESAR CHAVEZ AVE LOS ANGELES 90022 (323) 268-9191 22 4 7 2 1/9/2017

NUESTRA CLINICA INC 1588808547 4477 WHITTIER BLVD LOS ANGELES 90022-1535 (323) 264-2890 12 4 4 2 6/24/2009

QUEENSCARE HEALTH CENTERS 1104075282 4816 EAST THIRD STREET LOS ANGELES 90022-1602 (323) 780-4510 22 4 7 2 11/10/2010

Monday, March 23, 2020 Page 3 of 30

County of Los Angeles - Department of Public HealthChild Health And Disability Prevention Program

Active Providers

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

CO OF L.A. - ROYBAL COMPREHENSIVE HEALTH

1982617692 245 S FETTERLY AVE LOS ANGELES 90022-1605 (323) 362-1410 22 4 7 2 9/16/2004

MONTES MEDICAL GROUP INC 1437487956 4545 E 3RD ST STE 102 LOS ANGELES 90022-1656 (323) 266-7888 12 4 7 2 8/4/2010

JEYARANJAN, T MD 1669589644 284 S ATLANTIC BLVD LOS ANGELES 90022-1733 (323) 780-5884 13 4 7 2 2/17/1980

VIA CARE COMMUNITY HEALTH CENTER INC 1497001226 507 S. ATLANTIC BLVD LOS ANGELES 90022-2621 (323) 268-9191 22 4 7 2 1/6/2015

ALTAMED MEDICAL GROUP 1396959060 5427 WHITTIER BLVD LOS ANGELES 90022-4101 (888) 499-9303 22 4 7 2 8/1/1991

ALTAMED HEALTH SERVICES CORPORATION 1770006728 972 GOODRICH BLVD COMMERCE 90022-4114 (888) 499-9303 22 4 7 2 10/25/2018

MOJTAHEDIAN, EMMANUEL MD INC. 1609899087 6425 WHITTIER BLVD LOS ANGELES 90022-4603 (323) 728-0101 13 4 7 2 10/30/1992

BADYMOGHADDAM, YAGHOUB 1932225208 5726 E OLYMPIC BLVD LOS ANGELES 90022-5120 (323) 727-7000 13 4 7 2 1/24/2008

WOSK, SAMUEL MD / LA PROVIDENCIA MED INC

1609061431 3412 WHITTIER BLVD. LOS ANGELES 90023 (323) 264-4006 13 4 4 3 11/3/2008

RODRIGUEZ, MARIA E MD INC 1023179546 2417 WHITTIER BLVD LOS ANGELES 90023-1355 (323) 881-1641 13 4 4 3 3/21/2001

AMAVI, A PMC GUADALAJARA MED CLIN INC 1598984288 2705 WHITTIER BLVD LOS ANGELES 90023-1441 (323) 263-3861 12 4 4 3 2/12/1992

BELLA MEDICAL GROUP INC 1710261284A 2933 WHITTIER BLVD LOS ANGELES 90023-1528 (323) 263-2669 12 4 4 3 7/2/2013

ARDMORE MED GROUP INC 1770649097 3500 WHITTIER BLVD STE 105 LOS ANGELES 90023-1746 (323) 262-8100 12 4 4 3 5/27/1993

PEREZ, JOSE A., MD 1104991561A 3500 WHITTIER BLVD STE 107 LOS ANGELES 90023-1746 (323) 604-0260 13 4 6 3 1/14/2011

FIGUEROA, MANUEL I MD 1770679102 816 S INDIANA ST LOS ANGELES 90023-1820 (323) 262-5432 13 4 4 3 12/21/1994

ALTAMED MEDICAL - DENTAL GROUP, WHITTIER WEST

1255542601A 3945 WHITTIER BLVD LOS ANGELES 90023-2440 (323) 265-1998 22 4 4 3 8/26/2004

SAN MATEO MEDICAL CLINIC INC 1881795003 4055 WHITTIER BLVD LOS ANGELES 90023-2536 (323) 780-4000 12 4 4 3 1/22/1999

KIM, CHUNG W MD 1841363793 4082 E WHITTIER BLVD STE 102 LOS ANGELES 90023-2559 (323) 261-2111 13 4 4 3 6/17/1997

LIN, JOHN Y MD 1144392630 1148 S ROWAN AVE STE 2 LOS ANGELES 90023-3322 (323) 261-6173 13 4 4 3 12/29/1986

SHUE, RANDALL G DO INC 1679576730A 4055 E OLYMPIC BLVD STE 210 LOS ANGELES 90023-3345 (323) 268-3491 13 4 4 3 6/2/1989

ALTAMED MEDICAL AND DENTAL- ESTRADA COURTS

1255542601C 1305 S CONCORD STREET STE 18 LOS ANGELES 90023-3503 323-981-9816 22 4 4 3 10/15/2007

INTEGRATED HEALTHCARE MEDICAL GROUP INC

1801805056B 1762 WESTWOOD BLVD STE 110 LOS ANGELES 90024-5641 (310) 441-2000 12 4 5 3 12/7/2000

HOLLYWOOD SUNSET FREE CLINIC 1679691810 3324 SUNSET BLVD LOS ANGELES 90026-2190 323-660-7959 25 4 4 3 3/19/1986

HIGH DESERT WOMENS MEM / CLINICA SANTA MARIA ECHO

1033304894 711 N ALVARADO ST STE 104 AND 107

LOS ANGELES 90026-3333 (213) 483-3200 12 4 4 3 7/6/2011

CESAR VELEZ MEDICAL GROUP INC 1730231523 1411 W SUNSET BLVD., STE 203 LOS ANGELES 90026-3431 (213) 482-8313 12 4 4 3 4/7/2006

Monday, March 23, 2020 Page 4 of 30

County of Los Angeles - Department of Public HealthChild Health And Disability Prevention Program

Active Providers

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

AMH COMPREHENSIVE MEDICAL CENTERS 1306194105 711 NORTH ALVARADO ST SUITE 101

LOS ANGELES 90026-4016 (213) 484-8786 25 4 4 3 9/6/2017

QUEENSCARE HEALTH CENTERS 1013083666 150 N RENO ST LOS ANGELES 90026-4656 (213) 380-7298 22 4 4 3 11/15/2002

ASIAN PACIFIC HEALTH CARE VENTURE INC 1811129091 180 UNION PLACE LOS ANGELES 90026-5715 323-644-3885 22 4 4 3 3/25/2011

DOAN, YEN MD INC 1861587172 1663 BEVERLY BLVD STE 201 LOS ANGELES 90026-5747 (213) 413-4845 13 4 4 3 10/10/1984

ASIAN PACIFIC HLTH CARE INC 1003951708 3939 TRACY ST LOS ANGELES 90027-3207 (323) 665-1129 22 4 4 3 10/10/2006

ASIAN PACIFIC HEALTH CARE VENTURE, INC 1336208255 1530 HILLHURST AVE STE 200 LOS ANGELES 90027-5516 (323) 644-3880 22 4 3 3 9/10/2002

BEHROOZAN, BENJAMIN MD INC 1194949180 5255 W SUNSET BLVD LOS ANGELES 90027-5716 (323) 463-7262 12 4 4 3 9/10/1987

MINASSIAN, GUIRAGOS S MD 1871681817B 5000 SUNSET BLVD STE 640 LOS ANGELES 90027-5863 (323) 666-6202 13 4 4 3 6/27/1996

KOTOYAN, MARCOS MD 1841367091 1300 N VERMONT AVE STE 804 LOS ANGELES 90027-6005 (323) 662-9711 13 4 4 3 6/1/1983

WATCHI, RALPH MD APC 1003846189 1300 N. VERMONT AVE STE 901 LOS ANGELES 90027-6005 (323) 912-9221 13 4 4 3 1/15/1999

ALTAMED HEALTH SERVICES CORPORATION 1629283197A 4650 W SUNSET BLVD 1ST FLOOR, PAGE BLDG

LOS ANGELES 90027-6062 (323) 669-2113 22 4 4 3 5/17/2006

LAGMAN, ROSARIO MD 1053404376 1300 N VERMONT AVENUE STE 802-A

LOS ANGELES 90027-6069 (323) 660-6363 13 4 4 3 6/27/1996

ST ANTHONY MEDICAL CTR HOLLYWOOD CLINIC

1063562130 6368 HOLLYWOOD BLVD LOS ANGELES 90028-6320 323-469-5555 22 4 4 3 8/20/2012

ST JOHN URGENT CARE AND MED CORP 1710073390 1119 N WESTERN AVE SUITE G LOS ANGELES 90029-1070 (323) 957-9300 13 4 4 3 12/11/2008

HOLLYWOOD CROSS MEDICAL CLINIC INC 1649209743 1110 N WESTERN AVE STE 201 LOS ANGELES 90029-1087 (323) 463-6881 12 4 4 3 4/7/1995

QUEENSCARE HEALTH CENTERS- HOLLYWOOD 1639241888 4618 FOUNTAIN AVE LOS ANGELES 90029-1830 323-953-7170 22 4 4 3 9/24/2002

N ROSTAMI MEDICAL GROUP INC 1033256573 1080 N WESTERN AVENUE LOS ANGELES 90029-2310 (323) 957-8787 12 4 4 3 3/1/1996

JWCH INSTITUTE, INC 1598829350 954 N VERMONT AVE LOS ANGELES 90029-3529 (562) 869-7999 22 4 4 3 10/5/2017

SABABA, LILIAN E MD 1891806329 866 N VERMONT AVE LOS ANGELES 90029-3587 (323) 660-2100 13 4 4 3 6/16/1992

BANTA, DANTE A MD INC 1215100417 875 N WESTERN AVE LOS ANGELES 90029-3759 (323) 461-0777 13 4 4 3 12/21/1994

ARROYO VISTA FAMILY HEALTH CTR-LINCOLN HGHTS

1174665905 2411 N BROADWAY LOS ANGELES 90031-2218 (323) 987-2000 22 4 4 3 3/24/2006

LINCOLN HEIGHTS FAMILY INDUST GRP 1942309497 2409 N BROADWAY LOS ANGELES 90031-2218 (323) 225-8038 12 4 4 3 7/11/2005

ST JOHN'S WELL CHILD FAMILY CTR LINCOLN HGHTS

1932249505 2512 ALTA ST LOS ANGELES 90031-2457 (323) 541-1411 22 4 4 3 7/15/2005

CHIENG, AN P MD INC EL SERENO MED GRP 1336189117 3301 N EASTERN AVE LOS ANGELES 90032-1931 (323) 225-2351 12 4 4 3 1/25/1993

MOSAIC FAMILY CARE MEDICAL GROUP INC 1891830568 4857 HUNTINGTON DR N LOS ANGELES 90032-1939 (323) 226-9042 12 4 4 3 10/17/2002

ARROYO VISTA FAMILY HEALTH 1821302027 4837 HUNTINGTON DRIVE N LOS ANGELES 90032-1981 (323) 225-0024 22 4 4 3 4/30/2013

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

ARROYO VISTA FAMILY HEALTH CENTER 1316088479 4815 VALLEY BLVD STE C LOS ANGELES 90032-3300 (323) 222-1134 22 4 4 3 12/28/2001

LAC USC MEDICAL CENTER- VIOLENCE INTERVENTION PROGRAM

1396756938STA

2010 ZONAL AVE, OPD 3P61 LOS ANGELES 90033 323-226-5083 22 4 4 2 3/31/2003

MODERN CONCEPTS MED GRP INC 1386859619 1701 CESAR CHAVEZ AVE STE 354 LOS ANGELES 90033-0000 (323) 221-5366 12 4 4 3 9/27/2002

LAC USC MEDICAL CENTER - HIGH RISK PREMATURE INFANT CLINIC

1396756938STC

2010 ZONAL AVE 3P42B LOS ANGELES 90033-0123 (323) 409-3237 4 4 2 4/14/2017

LAC USC MEDICAL CENTER - OUTPATIENT PEDIATRIC DEPT.

1396756938STB

2010 ZONAL AVE OPD 5 EAST LOS ANGELES 90033-0123 323-226-3680 22 4 4 2 1/20/2016

CLINICA MSR OSCAR A ROMERO 1316033533 2032 MARENGO ST LOS ANGELES 90033-1319 (213) 989-7700 22 4 4 3 7/18/2006

ALTAMED MEDICAL AND DENTAL/RAMONA GARDENS

1255542601D 1424 CRUSADO LANE STE 168 LOS ANGELES 90033-1512 323-226-0623 22 4 4 3 10/22/2014

JAYASINGHE MED GROUP INC LOS ANGELES MEDICAL CTR

1457460503 319 N SOTO ST LOS ANGELES 90033-1837 (323) 266-6730 12 4 4 3 10/14/1983

RIVERA, MARTHA E MD INC 1689082232 1700 E CESAR E CHAVEZ AVE SUITE 3450

LOS ANGELES 90033-2424 323-261-0259 13 4 4 3 4/16/2015

THENAPPAN, ANNAPOORANI MD INC 1982959243 1701 E CESAR E CHAVEZ AVE STE 128

LOS ANGELES 90033-2464 (323) 223-2338 13 4 4 3 8/29/2006

FCS MEDICAL CORPORATION FAMILY CARE SPECIALISTS

1942255195 1701 E CESAR E CHAVEZ AVE STE 230

LOS ANGELES 90033-2496 (323) 226-1100 12 4 4 3 12/29/1992

FCS MEDICAL CORPORATION FAMILY CARE SPECIALISTS

1649223777 1701 CESAR CHAVEZ STE 402 LOS ANGELES 90033-2496 (323) 317-9200 12 4 4 3 11/30/2001

WHITE MEMORIAL COMMUNITY HEALTH CENTER

1083003321 1828 E CESAR E CHAVEZ AVE SUITE 5000

LOS ANGELES 90033-2496 (323) 987-1200 25 4 4 3 8/24/2017

COMPLETE CARE COMM HLTH CTR 1215113964A 2928 E CESAR E CHAVEZ AV LOS ANGELES 90033-3110 (323) 266-6700 22 4 4 3 1/3/2013

ALTAMED HEALTH SERVICES CORP EAST LA 1ST STREET

1134492937 2219 E 1ST STREET LOS ANGELES 90033-3901 (323) 647-6202 22 4 4 3 7/22/2009

LOS ANGELES CHRISTIAN 1457599631 1625 E 4TH ST LOS ANGELES 90033-4201 (323) 893-1960 22 4 4 3 11/23/2009

USC CARE MEDICAL GROUP INC 1902846306A 1520 SAN PABLO ST STE 1300 LOS ANGELES 90033-5312 (323) 442-5900 12 4 4 3 12/22/2009

ALFRED LAVI DO PROFESSIONAL 1629198791B 1835 S. LA CIENEGA BLVD STE. 205 AND 215

LOS ANGELES 90035-4651 (310) 836-2273 12 4 6 3 12/26/2012

CLINICA DE LOS ANGELES MEDICAL GROUP INC

1184754996 4301 S FIGUEROA ST STE F LOS ANGELES 90037-2671 (323) 231-7700 12 4 6 3 11/30/2004

GILL, CADRIN E MD 1891851861 231 W VERNON AVE STE 101, 201 LOS ANGELES 90037-2779 (323) 231-5181 13 4 6 3 5/1/1987

GAGE MEDICAL CLINIC INC 1003053943 985 W VERNON AVE LOS ANGELES 90037-3038 323-881-9620 12 4 6 3 1/25/2016

SWEENY, ALFREDO MD INC SUNSET FAMILY MED CLINIC

1962538173 4719 S BROADWAY LOS ANGELES 90037-3244 (323) 231-9983 12 4 6 3 9/29/2001

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

ST JOHNS WELL CHILD AND FAMILY CENTER INC

1598002628 808 W 58TH ST LOS ANGELES 90037-3632 (213) 400-6056 22 4 6 3 12/30/2013

ST JOHNS WELL CHILD AND FAMILY CENTER 1013057371 5701 S HOOVER ST LOS ANGELES 90037-4045 (323) 541-1411 22 4 6 3 12/19/2007

ST JOHNS WELL CHILD AND FAMILY CENTER INC

1396981700 4085 S VERMONT AVE LOS ANGELES 90037-4045 (323) 541-1631 22 4 6 3 6/17/2009

SOCAL HEALTHNET INC 1487832655 5912 SANTA MONICA BLVD LOS ANGELES 90038-2043 (323) 461-3888 12 4 4 3 6/26/2008

THE LOS ANGELES FREE CLINIC HOLLYWOOD WILSHIRE HLTH

1336281179A 5205 MELROSE AVE LOS ANGELES 90038-3144 (323) 653-8622 22 4 4 3 4/1/2003

COMPREHENSIVE COMMUNITY HEALTH CTR-EAGLE ROCK

1679553192 1704 COLORADO BLVD LOS ANGELES 90041-1338 (323) 256-4116 22 4 4 3 9/22/2004

QUEENSCARE HEALTH CENTERS 1801967062 4448 YORK BLVD LOS ANGELES 90041-3328 (323) 344-5233 22 4 4 3 11/12/2002

NORTHEAST COMM CLINIC 1700097540STA

5420 N FIGUEROA ST LOS ANGELES 90042 (323) 256-3884 22 4 4 3 5/1/1995

COMPREHENSIVE COMMUNITY HLTH CTR-HIGHLAND PARK

1245210749 5059 YORK BLVD LOS ANGELES 90042-1713 (323) 344-4144 22 4 4 3 9/9/2004

COMPREHENSIVE COMMUNITY HLTH CTR-HIGHLAND PARK

1356362743STA

5059 YORK BLVD LOS ANGELES 90042-1713 323-344-4144 22 4 4 3 9/9/2004

FCS MEDICAL CORPORATION FAMILY CARE SPECIALISTS

1982657029 5823 YORK BLVD STE 1 LOS ANGELES 90042-2634 (323) 255-1575 12 4 4 3 12/16/1991

ARROYO VISTA FAMILY HEALTH CENTER 1447353701 6000 N FIGUEROA ST LOS ANGELES 90042-4232 (323) 254-5221 22 4 4 3 1/6/1992

ARROYO VISTA FAMILY HEALTH CTR MOBILE II 1891837621 6000 N FIGUEROA ST LOS ANGELES 90042-4232 (323) 254-5221 22 4 4 3 1/19/2006

T.H.E. CLINIC, INC 1023287679STD

3206 W 50TH AVENUE LOS ANGELES 90043 (323) 730-1920 22 4 6 3 3/2/2016

ST JOHNS WELL CHILD 1003068206 6505 8TH AVE LOS ANGELES 90043-4313 (323) 541-1600 22 4 6 3 7/7/2009

MORNINGSIDE PRIMARY CARE MEDICAL CENTER INC.

1730299157 617 W MANCHESTER AVE. LOS ANGELES 90044-0000 (323) 750-9715 12 4 8 3 3/23/2006

GREEN CROSS MED NET INC 1851609176 5832 S VERMONT AVE LOS ANGELES 90044-3712 323-750-7354 12 4 8 3 10/28/2014

ST ANTHONY MEDICAL CTR IMPERIAL CLINIC 1225188204 837 W IMPERIAL HWY LOS ANGELES 90044-4110 (323) 755-9555 22 4 8 3 8/30/2012

WILMINGTON COMMUNITY CLINIC 1932194586STA

10901 S VERMONT AVE LOS ANGELES 90044-4505 (323) 241-6717 22 4 8 3 9/16/2004

UNIVERSITY MUSLIM MED UMMA COMMUNITY CLINIC

1720171242 711 W FLORENCE AVE LOS ANGELES 90044-6105 (323) 789-5610 22 4 8 3 4/10/2006

CALVARY MEDICAL CLINIC, INC LOS ANGELES MED CTR

1295976199 11502 S VERMONT AVE. SUITE A LOS ANGELES 90044-6522 (323) 757-1557 13 4 8 3 1/6/2009

AXMINSTER MEDICAL GROUP INC 1801897368 8540 S SEPULVEDA BLVD STE 818 LOS ANGELES 90045-3808 310-670-3255 12 4 5 3 11/26/2012

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

FLORENCE WESTERN MEDICAL CLINIC INC 1154347797 7301 WESTERN AVE LOS ANGELES 90047-2254 (323) 778-2131 12 4 6 3 6/28/2006

ELDESSOUKY, AMANI A MD INC 1528074044 1704 W MANCHESTER AVE STE 109 LOS ANGELES 90047-3034 (323) 778-8485 13 4 6 3 6/22/2006

ST JOHNS WELL CHILD AND FAMILY CENTER INC

1972845113 1555 W 110TH ST LOS ANGELES 90047-4622 (323) 757-2775 22 4 6 3 11/10/2014

ST JOHNS WELL CHILD AND FAMILY CENTER INC

1629491089 1555 W 110TH STREET LOS ANGELES 90047-4622 (323) 757-2775 25 4 8 3 9/3/2015

CEDARS-SINAI MED CTR (C.O.A.C.H. FOR KIDS PROG I)

1639172372STA

8700 BEVERLY BLVD., TSB 210 LOS ANGELES 90048-1804 (323) 866-6845 2 4 4 3 12/17/1987

CEDARS-SINAI MED CTR C.O.A.C.H. FOR KIDS PROGRAM II

1639172372STB

8700 BEVERLY BLVD. TSB 210 LOS ANGELES 90048-1804 (323) 866-6845 2 4 4 3 5/16/2002

CEDARS-SINAI MEDICAL CENTER 1639172372 8700 BEVERLY BLVD., RM 1473 LOS ANGELES 90048-1804 (310) 423-6321 2 4 4 3 12/17/1987

GROVER, RAHUL INC 1497970115A 8733 BEVERLY BLVD STE 200 WEST HOLLYWOOD

90048-1844 (310) 652-3981 12 4 4 3 8/24/2009

ALTAMED HEALTH SERVICES INTERMITTENT 1629283197B 2100 WEST 3RD STREET STE. 200 LOS ANGELES 90057 (213) 413-8742 22 4 4 3 5/12/2014

CLINICA MSR OSCAR ROMERO 1275629495 123 S ALVARADO STREET LOS ANGELES 90057-2201 (213) 989-7700 22 4 4 3 3/20/2001

LOPEZ, HORACIO G MD INC 1659430460 2105 BEVERLY BLVD STE 129 LOS ANGELES 90057-2216 (213) 353-3600 13 4 4 3 5/16/1995

SUYAT, GEORGE U MD MPH INC 1801063300 2105 BEVERLY BLVD STE 131 LOS ANGELES 90057-2263 213-413-8836 13 4 4 3 2/9/1999

MERCADER, ROLANDO S MD INC 1376036178 201 SOUTH ALVARADO ST STE 600 LOS ANGELES 90057-2354 (213) 484-6694 13 4 4 3 5/3/1993

GONZALES, ROMMEL MEDICAL GROUP INC 1275965105 508 S ALVARADO ST LOS ANGELES 90057-2904 213-483-3600 13 4 4 3 11/5/2015

MICHAEL GITTER MD INC 1265668784 2011 WILSHIRE BLVD LOS ANGELES 90057-3505 (213) 484-4444 12 4 4 3 2/16/2010

WALTER JAYASINGHE MD APC/LOS ANGELES MEDICAL CTR

1730282286 2010 WILSHIRE BLVD FL 2 LOS ANGELES 90057-3507 (213) 483-9209 12 4 4 3 12/4/1990

PAJA MEDICAL GROUP INC OLYMPIC FAMILIA CLNC INC

1053367896 1800 WILSHIRE BLVD LOS ANGELES 90057-3602 (213) 484-9934 12 4 4 3 11/14/2005

BAUTISTA, DAISY I MD A MEDICAL CORPORATION

1689691537 1930 WILSHIRE BOULEVARD, SUITE 803

LOS ANGELES 90057-3636 (323) 600-4037 13 4 4 3 7/3/1996

LOS ANGELES CLINICA MEDICA GENERAL MED. CTR. INC.

1265489751 2208 W 7TH ST LOS ANGELES 90057-4002 (213) 384-3434 12 4 4 3 7/20/2009

KOHANZADEH, SHAHLA MD / CLINICA MEDICA SANTA MARIA

1649338914 803 S ALVARADO ST LOS ANGELES 90057-4009 (213) 381-1117 13 4 4 3 5/15/2007

TORKAN, BRUCE MD INC. CLINICA MEDICA FATIMA

1487659116 820 S. ALVARADO ST LOS ANGELES 90057-4010 (213) 384-0604 12 4 4 3 10/13/1994

YUN, EUN MI MD 1609987486 819 S. ALVARADO STREET STE 101 LOS ANGELES 90057-4018 (213) 388-6000 13 4 4 3 8/6/1991

HEALTH ACCESS FOR ALL INC 1447703400 1919 WEST 7TH ST 2ND & 3RD FLOOR

LOS ANGELES 90057-4103 (310) 703-3667 25 4 4 3 1/10/2019

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

CO OF L.A. - MARTIN LUTHER KING, JR/DREW MEDICAL CTR

1245343052STA

1721 E 120TH STREET LOS ANGELES 90059 424-338-2900 22 4 6 3 5/5/1975

BENEVOLENCE INDUSTRIES INC 1457781676 611 E IMPERIAL HWY, SUITE 107 LOS ANGELES 90059-2358 (323) 732-0100 22 4 6 3 2/12/2020

WATTS HEALTHCARE 1477649119B 316 E 111TH STREET LOS ANGELES 90061-3004 323-450-2376 25 4 6 3 6/21/2016

T.H.E. CLINIC AT RUTH TEMPLE HEALTH CENTER

1023287679 3834 S WESTERN AVE LOS ANGELES 90062-1104 (323) 730-1920 22 4 6 3 6/5/1998

PEACE, DEVAUGHN K MD INC 1831103779 4326 S WESTERN AVE LOS ANGELES 90062-1648 (323) 299-9914 13 4 6 3 6/17/1986

CUIDADO LATINO MEDICAL CLINIC INC 1376862607 3710 E CESAR CHAVEZ AVE LOS ANGELES 90063-2219 (323) 980-7777 13 4 7 2 4/4/2012

BOZORGNIA, LEILA M D INC 1912264722 2990 S SEPULVEDA BLVD SUITE 202 LOS ANGELES 90064-3973 (424) 277-2020 13 4 5 3 2/25/2019

PEDRANO, GUADALUPE C MD INC 1720186786 2209 SAN FERNANDO ROAD LOS ANGELES 90065-1231 (323) 226-0511 13 4 4 3 11/28/1989

TRACY, ROBERT DO INC 1083005474 3056 FLETCHER DRIVE LOS ANGELES 90065-2207 323-256-2231 12 4 4 3 3/12/2018

ALL-INCLUSIVE COMMUNITY HEALTH CENTER 1174996177 3920 EAGLE ROCK BLVD SUITE A LOS ANGELES 90065-3606 (323) 255-5225 4 4 3 5/11/2017

BASS, BRENDA G MD 1477627248 9201 W SUNSET BLVD STE 408 LOS ANGELES 90069-3705 (310) 273-7401 13 4 4 3 11/13/1981

UCLA DEPT OF PEDIATRICS GRP PRACTICE 1982667663 200 UCLA MED PLAZA CHILDRENS HLTH CTR STE 265

LOS ANGELES 90095-3075 (310) 825-0867 12 4 5 3 12/24/1992

CLINICA MEDICA CUZCATLAN/CUZCATLAN MEDICAL CLINIC

1821215914 3559 E GAGE AVE BELL 90201-1042 (323) 581-8485 12 4 7 2 3/3/2003

NORTHEAST COMMUNITY CLINIC 1124460274STD

4129 E GAGE AVE BELL 90201-1128 (323)771-8400 22 4 7 2 5/5/2004

PACIFIC WOMEN'S MEDICAL CLINIC 1538203971A 4750 GAGE AVE BELL 90201-1351 (323) 562-1100 13 4 7 2 6/18/2002

M ZARRABI MEDICAL CORPORATION 1699767517 4827 GAGE AVENUE BELL 90201-1424 (323) 773-3000 12 4 7 2 9/4/2003

FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES INC

1215310008 6119 AGRA STREET BELL GARDENS 90201-1705 (562) 928-9600 22 4 7 3 10/5/2017

FAMILY HEALTH CARE CENTERS GREATER LOS ANGELES INC

1720115033 6501 GARFIELD AVE BELL GARDENS 90201-1805 (562) 928-9600 22 4 7 3 11/17/2003

AZUL MEDICAL CLINIC, INC 1679626436 6517 EASTERN AVE BELL GARDENS 90201-3003 (323) 773-8295 12 4 7 2 10/27/2004

VAZQUEZ, CAROLINA MD APC 1780974410 6501 EASTERN AVENUE STE A BELL GARDENS 90201-3003 (323) 771-0145 13 4 7 2 7/5/2012

MCMILLAN, SAMUEL MD 1962560870 6300 FLORENCE AVE BELL GARDENS 90201-3293 (562) 928-9700 12 4 7 2 1/6/2010

BATRES , ERIC R MD MEDICAL CORP 1083735203 5101 FLORENCE AVE STE 4 BELL 90201-3801 (323) 560-4673 13 4 7 2 12/10/2004

JWCH INSTITUTE INC 1295829109 6912 AJAX AVE. BELL GARDENS 90201-4057 (562) 867-7999 22 4 7 2 9/6/2005

TORRES AND UYUNI A PROFESSIONAL MEDICAL COR

1972973840 4566 E FLORENCE AVE STE 1 CUDAHY 90201-4345 323-771-1433 12 4 7 2 6/29/2016

PRIETO, JOSE NORBERTO MD 1407942311 4566 FLORENCE AVE. STE 2 CUDAHY 90201-4346 (323) 582-7186 13 4 7 2 5/5/1999

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

GARDENS MEDICAL CENTER INC. 1891839270 7218 GARFIELD AVE BELL GARDENS 90201-4812 (562) 927-1111 12 4 7 2 9/24/2008

SHAFAI, JAMSHID MD INC MEDICAL GROUP INC

1467633586 7601 ATLANTIC AVENUE CUDAHY 90201-5019 (323) 562-3500 12 4 7 2 10/28/1996

HEKMAT, FARAH L MD 1073655841 9301 WILSHIRE BLVD STE 402 BEVERLY HILLS 90210-6134 (310) 276-0541 13 4 5 3 12/5/2008

JANESRI DE SILVA MD A PROFESSIONAL CORP 1326278490B 240 S. LA CIENEGA BLVD SUITE 350 BEVERLY HILLS 90211 323-664-1977 13 4 5 3 4/3/2008

ONYEADOR, EJIKE C, MD 1699841700 555 W COMPTON BLVD STE 205 COMPTON 90220-3037 (310) 223-0684 13 4 6 3 9/22/1995

AGHABY COMPREHENSIVE COMMUNITY HEALTH CENTER

1922490960 349 W COMPTON BLVD COMPTON 90220-3110 (424) 785-5170 25 4 6 3 9/1/2017

KYAZZE, FRED B MD INC 1528350014 1410 W. ALONDRA BLVD. SUITE C COMPTON 90220-3533 (310) 637-3680 13 4 6 3 8/6/1999

PROHEALTH PARTNERS A MEDICAL 1821429838 711 EAST ROSECRANS AVE COMPTON 90221-2143 310-635-5223 12 4 6 3 4/25/2016

DE NOVO HEALTH CARE INC 1972752368 803 ROSECRANS AVE COMPTON 90221-2145 (310) 605-4800 25 4 6 3 10/20/2011

BENEVOLENCE INDUSTRIES INCORPORATED 1821469263 920 N LONG BEACH BLVD SUITE 1, 2, 3

COMPTON 90221-2259 (323) 732-0100 25 4 6 3 2/20/2020

ST JOHNS WELL CHILD AND FAMILY CENTER INC

1801028303 15301 S. SAN JOSE AVE COMPTON 90221-3131 (562) 630-6825 22 4 6 3 10/4/2012

AUSTIN, EDWARD MD 1245383488 1331 E COMPTON BLVD COMPTON 90221-3401 (310) 763-4250 13 4 6 3 8/7/1998

THE ROADS FOUNDATION INC 1508278359 121 S LONG BEACH BLVD COMPTON 90221-3423 310-627-5850 22 4 3 7/7/2016

JOHNSON-CHAVIS, TONI D MD INC 1083728190A 403 S LONG BEACH BLVD STE B COMPTON 90221-3491 (323) 774-6551 13 4 6 3 12/5/1988

ST JOHNS WELL CHILD FAMILY CENTER INC 1043542111 15715 S ATLANTIC AVE 2 E RANCHO DMNGZ 90221-4242 (310) 898-6428 22 4 6 3 11/10/2010

HEALTH CARE INTEGRATED SERVICES 1124405881 2600 N CENTRAL AVENUE COMPTON 90222-1640 888 417-5163 25 4 5 3 7/10/2019

ST JOHN'S WELL CHILD CTR COMPTON 1932249596 2115A N WILMINGTON AVE COMPTON 90222-2030 (310) 603-1332 22 4 6 3 4/23/2005

WE CARE MORE II FAMILY CLINIC 1962683938 2110A N SANTA FE AVE COMPTON 90222-2822 (310) 637-7131 12 4 6 3 9/16/2008

CO OF L.A. - DOLLARHIDE HEALTH CENTER 1235247578 1108 N. OLEANDER AVE COMPTON 90222-4041 (310) 763-2244 22 4 6 3 9/19/2005

BALLOU, NICOLETTE L MD 1457420077 3831 HUGHES AVENUE SUITE 602 CULVER CITY 90230 (310) 659-7867 13 4 5 3 7/16/1986

THE ACHIEVABLE FOUNDATION 1164771747 5901 GREEN VALLEY CIRCLE STE. 405

CULVER CITY 90230 (424) 266-7474 22 4 5 3 8/19/2014

VENICE FAMILY CLINIC COLEN FAMILY HEALTH CTR

1003842360 4700 INGLEWOOD BLD SUITE 102 CULVER CITY 90230-5896 (310) 392-8636 22 4 5 3 10/18/2007

PROSPERA GROUP CORP 1285711937B 3831 HUGHES AVE STE 602 CULVER CITY 90232-6845 (310) 204-6897 13 4 5 3 3/10/2009

JAZAYERI, AZAM MD 1972523728 3831 HUGHES AVE., STE. 502 CULVER CITY 90232-6858 (310) 558-8895 13 4 5 3 1/26/1994

SAKHAI, YUSSEF MD INC 1841551108 5797 WASHINGTON BLVD CULVER CITY 90232-7336 323-452-9686 13 4 5 3 10/8/2015

MLS CLINICAL & MEDICAL CORPORATION 1912146887 8530 FLORENCE AVE SUITE 101 DOWNEY 90240 (562) 928-4642 13 4 7 3 8/23/2005

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

CRUZ, MARILOU G MD INC 1619232808 8535 FLORENCE AVE SUITE 201 DOWNEY 90240-4014 (562) 861-1245 13 4 7 3 5/11/1999

ISKAROUS, RAGAA Z, MD INC 1215035274 11003 LAKEWOOD BLVD., STE 201 DOWNEY 90241-3876 (562) 869-1038 13 4 7 3 6/13/2002

TENDER CARE COMMUNITY CLINIC INC 1134668304 7862 FIRESTONE BLVD DOWNEY 90241-4221 (562) 869-7007 25 4 7 3 2/10/1994

JWCH INSTITUTE INC 1770988370 8530 FIRESTONE BLVD DOWNEY 90241-4926 562-867-7999 22 4 7 3 6/6/2016

ZUNIGA, JOCELYN C MD INC 1386682623 11525 BROOKSHIRE AVE STE 302 DOWNEY 90241-4982 (562) 904-2821 13 4 7 3 11/7/2007

ROY, RITA MD 1306900832 11480 BROOKSHIRE AVE STE 105 DOWNEY 90241-5020 (562) 622-1100 13 4 7 3 12/11/1981

FAMILY HEALTH CARE CENTER OF GREATER LA INC

1790051423 12113 WOODRUFF AVE STE A DOWNEY 90241-5605 (562) 231-5600 22 4 7 3 7/1/2014

BAEZ, ALFONSO M MD 1134295132 14127 S VERMONT AVE GARDENA 90247-2205 (310) 532-1650 13 4 8 3 4/25/1994

HOGAN, ANJANETTE MD INC 1457447393 1141 W REDONDO BCH STE 409 GARDENA 90247-3528 (310) 532-0308 13 4 6 3 6/28/2006

SOUTH ATLANTIC MEDICAL GROUP INC 1306029806 1146 W REDONDO BEACH BLVD GARDENA 90247-3538 (310) 323-9999 12 4 8 3 1/21/1992

AZIZ-ZADEH, NASSER 1093723371 1141 W REDONDO BEACH BLVD STE 407

GARDENA 90247-3582 (310) 527-5554 13 4 8 3 7/1/1992

CORONEL-PEREY, ANNETTE A., MD INC 1952670341 1045 W. REDONDO BEACH BLVD., STE. 100

GARDENA 90247-3583 (310) 532-5558 13 4 8 3 4/12/2001

MOCEGA, JUAN A MD JR INC 1093954018 1141 W REDONDO BEACH BLV STE 308

GARDENA 90247-3583 (310) 807-9477 13 4 8 3 1/21/2010

BALETTE, LILY C MD 1902960388 1141 WEST REDONDO BEACH BLVD STE 211

GARDENA 90247-3584 (310) 327-0245 13 4 8 3 6/2/2009

SOUTH BAY FAMILY HEALTHCARE CENTER 1871634568 742 W GARDENA BLVD GARDENA 90247-5024 (310) 327-1357 22 4 8 3 11/2/2004

GOLBARI, ABRAHAM MD INC 1396047775 14030 CRENSHAW BLVD GARDENA 90249-2715 (310) 327-8746 13 4 8 3 5/29/2003

KEVORKIAN, VICTOR A MD A PROFESSIONAL CORP.

1952496663 14111 VAN NESS AVE STE. 4 GARDENA 90249-2944 (310) 516-9152 13 4 8 3 7/7/1982

THE NORTHEAST COMMUNITY CLINIC 1891028171 4455 W 117 ST STE 300 HAWTHORNE 90250-2240 (310) 645-0444 22 4 8 3 11/23/2010

THE NORTHEAST COMMUNITY CLNC INTERMITTENT

1700097540B 4455 W 117TH ST SUITE 200 HAWTHORNE 90250-2240 (310) 219-2000 22 4 4 3 3/17/2020

ISKANDER, MONA Y MD INC 1679580880 4477 W 118TH ST STE 301 HAWTHORNE 90250-2257 (310) 978-8026 13 4 8 3 11/30/1987

LA COMMUNITY CARE MED ASSOCIATES 1801099486 11633 HAWTHORNE BLVD STE 103 HAWTHORNE 90250-2323 (310) 219-2929 12 4 8 3 5/4/1998

AWADA, ALI MD INC 1356531297 12301 S HAWTHORNE BLVD HAWTHORNE 90250-2369 (310) 355-0054 13 4 8 3 4/4/2006

NABIL AND JANET F SOLIMAN CENTRO MEDICO INC

1497776322 11946 S HAWTHORNE BLVD HAWTHORNE 90250-3016 (310) 675-1136 13 4 8 3 1/13/2004

BEHAVIORAL HEALTH SERVICES INC 1548659105 2501 W EL SEGUNDO BLVD SUITE B HAWTHORNE 90250-3317 (424) 456-8933 22 4 8 3 10/18/2017

HAWTHORNE MORNINGSIDE MEDICAL CLINIC 1477692408 12954 HAWTHORNE BLVD STE 104 HAWTHORNE 90250-4418 (310) 679-0269 12 4 8 3 3/23/2004

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

SAINT PAUL MEDICAL CTR OF THE SOUTH BAY 1447262522 12923 INGLEWOOD AVE STE 1 HAWTHORNE 90250-5139 (310) 675-0395 12 4 8 3 2/26/1990

HERNANDEZ, VALENTIN MD INC 1871520320 13440 HAWTHORNE BLVD HAWTHORNE 90250-5806 (310) 219-0941 13 4 8 3 7/30/2010

HOANG, DAVID N DO 1861758831 13672 HAWTHORNE BLVD HAWTHORNE 90250-5810 310-644-5097 13 4 8 3 3/25/2016

NGUYEN, LIEU S MD APC 1215021167 15032 S PRAIRIE AVE HAWTHORNE 90250-8316 (310) 675-7343 13 4 8 3 10/13/1988

AGHABY COMPREHENSIVE COMMUNITY HEALTH CTR

1922490960STA

2542 E FLORENCE AVENUE STE B WALNUT PARK 90255 (323) 584-8700 22 4 7 2 4/27/2009

AGUILAR, DAVID G MD 1730291287 7705 SEVILLE AVE STE D HUNTINGTON PARK

90255 (323) 582-6534 13 4 7 2 5/16/2016

KATIRAIE, SEPEHR MD INC 1508136326 2638 E FLORENCE AVE HUNTINGTON PARK

90255 (323) 588-3800 13 4 7 2 11/2/2000

NORTHEAST COMMUNITY CLINICS 1124460274 2975 ZOE AVENUE HUNTINGTON PARK

90255 323-826-9449 22 4 7 2 8/3/2013

ALTAMED HEALTH SERVICES CORPORATION 1790177582 1900 E SLAUSON AVE HUNTINGTON PARK

90255-2725 323-487-4110 22 4 7 2 4/1/2019

CLINICA PACIFICA MEDICAL GROUP 1316111933 2550 E SLAUSON AVE. SUITE G HUNTINGTON PARK

90255-2820 (323) 581-0791 12 4 7 2 8/4/1994

HEALTH ACCESS FOR ALL INC 1295288348 6208 SEVILLE AVE HUNTINGTON PARK

90255-2913 (310) 703-3667 22 4 7 2 2/25/2019

SOLIMAN, TAHANI MD INC 1902906985 6526 RUGBY AVE HUNTINGTON PK 90255-4006 (323) 583-2247 12 4 7 2 1/13/2005

CROWN CITY MEDICAL GRP INC 1508989500 6601 RUGBY AVE. STE 300 HUNTINGTON PK 90255-4040 (323) 582-1177 12 4 7 2 8/15/1990

MAYER, RALPH MD 1194866525 2568 CLARENDON AVE HUNTINGTON PK 90255-4073 (323) 582-5444 12 4 7 2 6/19/2007

HUNTINGTON PARK CLINICA MEDICA GENERAL,

1942256094 6347 PACIFIC BLVD HUNTINGTON PARK

90255-4101 (323) 583-8383 12 4 7 2 10/20/1997

GAGE MEDICAL CENTER 1891904686 2719 E GAGE AVE HUNTINGTON PARK

90255-4202 (323) 277-0272 12 4 7 2 10/18/2005

SOUTH CENTRAL FAMILY HEALTH CENTER (SCFHC)

1669799896 2680 SATURN AVE STE 110, 220, 280

HUNTINGTON PARK

90255-4568 (323) 908-4200 22 4 7 2 7/13/2012

HIGH DESERT WOMENS MEMORIAL MEDICAL CTR APC

1023203882 2680 E FLORENCE AVE HUNTINGTON PARK

90255-4708 (323) 581-4665 12 4 7 2 7/21/2011

LAKHA, RUMI K DO INC 1750434866 7136 PACIFIC BLVD STE 225 HUNTINGTON PARK

90255-4767 (323) 588-5467 13 4 7 2 6/16/2017

GALDAMEZ, LUIS A MD INC CLINICA MEDICA VIRGEN DE GUADALUPE

1033240650 6831 SEVILLE AVE HUNTINGTON PK 90255-4805 (323) 581-8234 12 4 7 2 12/2/2005

ALIANZA MEDICAL CENTER INC 1073675385 6907 SEVILLE AVE HUNTINGTON PARK

90255-4901 (323) 588-1100 12 4 7 2 3/12/1998

ZEVALLOS, EDWIN W MD 1821139205 6915 SEVILLE AVENUE HUNTINGTON PK 90255-4901 (323) 588-9800 13 4 7 2 9/26/1997

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

TORREBLANCA, JOSE MD INC 1104247329 7128 SEVILLE AVE HUNTINGTON PARK

90255-4906 323-588-2186 12 4 7 2 5/15/2019

NORTHEAST COMMUNITY CLINICS 1881987576 2822 E FLORENCE AVENUE HUNGTINGTON PARK

90255-5749 (323) 923-1900 22 4 7 2 4/30/2012

ARDMORE MEDICAL GROUP INC 1235299637 2765 E. FLORENCE AVENUE HUNTINGTON PARK

90255-5750 (323) 588-6888 12 4 7 2 8/19/1995

BAYLON, PAUL M MD 1003824020 3118-3120 E FLORENCE AVE HUNTINGTON PARK

90255-5830 (323) 587-1616 13 4 7 2 5/12/2011

GAGE MEDICAL CLINIC INC. R OF HUNTINGTON PARK

1477069375 3203 E FLORENCE AVE HUNTINGTON PARK

90255-5831 (323) 835-6310 12 4 7 2 11/20/2018

DEL ROSARIO MEDICAL CLINIC, INC 1659419307 3400 E FLORENCE AVE HUNTINGTON PK 90255-5835 (323) 589-9384 12 4 7 2 8/22/1996

GALDAMEZ, LUIS A MD INC 1225168024 2955 E FLORENCE AVE HUNTINGTON PK 90255-5836 323-585-0732 12 4 7 2 10/9/2014

AZURIN, ELEANOR MD INC 1538278270 3045 E FLORENCE AVE HUNTINGTON PK 90255-5837 (323) 587-7771 13 4 7 2 3/13/2002

ABDEL- MALEK, SHAHIRA MD INC 1508088840 3100 E FLORENCE AVE STE 1 HUNTINGTON PK 90255-5848 (323) 583-4115 12 4 7 2 9/24/1997

NGUYEN, TAO T MD INC 1861587073 3100 E FLORENCE AVE STE 9 HUNTINGTON PARK

90255-5848 (323) 583-6516 13 4 7 2 5/6/1993

L A STAR MEDICAL GROUP INC 1386025773 4161 REDONDO BEACH BLVD SUITE 100

LAWNDALE 90260-1477 (310) 214-1407 12 4 8 3 4/10/2017

CHAFIK, DAKAK MD INC 1376563957 3737 MARTIN LUTHER KING BLVD. STE 205

LYNWOOD 90262-0000 (310) 604-0105 13 4 6 3 11/17/1998

CHAN, CONSTANT K S MD INC 1225347438 10007 STATE STREET LYNWOOD 90262-1514 (323) 566-3157 13 4 6 3 10/25/1984

ST FRANCIS MULTISPCLTY 1225076383 3628 E IMPERIAL HWY STE 303 LYNWOOD 90262-2646 310-900-7360 12 4 6 3 1/1/2002

ST JOHNS WELL CHILD AND PRIMARY CARE CLINIC

1063836526 3628 E IMPERIAL HWY SUITE 301 LYNWOOD 90262-2646 (310) 900-7365 22 4 6 3 10/4/2016

SUPNET, MEDARDO C MD INC 1699923235 3585 E IMPERIAL HWY LYNWOOD 90262-2654 (310) 605-4260 12 4 6 3 12/15/1993

PEDIATRIC AND FAMILY MEDICAL CENTER 1407268709 3680 E IMPERIAL HWY STE 200 LYNWOOD 90262-2659 310-608-4898 22 4 6 3 8/8/2016

KARAMEDIN, FRANGIS MD 1275600249 3680 E IMPERIAL HWY STE 306 LYNWOOD 90262-2662 (310) 609-1500 13 4 6 3 8/4/1997

JWCH INSTITUTE INC 1124182977 3591 E IMPERIAL HIGHWAY LYNWOOD 90262-2684 (562) 867-7999 22 4 6 3 11/26/2012

CLINICA FAMILIAR SAN LUCAS 1043462443 11050 S ATLANTIC AVE LYNWOOD 90262-3068 (310) 635-3800 12 4 6 3 4/21/2009

TAN, TERENCE T MD / TERENCE T Z TAN MD INC

1699822239 3301 BEECHWOOD AVENUE LYNWOOD 90262-3301 (310) 638-5188 13 4 6 3 12/8/1992

SAUNDERS, JAMES E MD INC 1326414491 3737 MARTIN LUTHER KING STE 204

LYNWOOD 90262-3526 310-537-1221 13 4 6 3 3/15/1983

ASWANI, MOHINI MD INC. 1811006943 3737 MARTIN LUTHER KING JR BLVD STE 205

LYNWOOD 90262-3527 (310) 604-0105 13 4 6 3 11/30/1982

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

AMH COMPREHENSIVE MEDICAL CENTERS 1306194105STA

6017 ATLANTIC BLVD MAYWOOD 90270 (323) 560-8880 25 4 7 2 1/22/2020

ARDMORE MED GROUP INC 1992873947 4528 E SLAUSON AVE MAYWOOD 90270 (323) 562-6170 12 4 7 2 8/30/2004

FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES

1922416411 4943 SLAUSON AVENUE MAYWOOD 90270-3020 562-928-9600 22 4 7 2 11/2/2016

MAYWOOD FAMILY MEDICAL CENTER RAGAA Z ISKAROUS

1801184841 5920 ATLANTIC BLVD MAYWOOD 90270-3101 (323) 562-2535 13 4 7 2 1/10/2012

BASILIOS, MAGED MD INC 1326459256 4505 E SLAUSON AVE STE E MAYWOOD 90270-4955 323-771-0080 13 4 7 2 11/23/2004

SOUTH BAY FAMILY HEALTH-CARE CENTER 1548301229 2114 ARTESIA BLVD REDONDO BEACH 90278-3014 (310) 318-2521 22 4 8 3 11/2/2004

INTEGRATED HEALTHCARE MEDICAL GROUP, INC

1801805056A 2850 ARTESIA BLVD STE 105 REDONDO BEACH 90278-3412 (310) 214-8000 12 4 8 3 12/13/1999

LA LIBERTAD MEDICAL CLINIC INC 1295887024 8225 LONG BEACH BLVD STE C SOUTH GATE 90280-2010 (323) 585-1056 13 4 7 3 5/30/1996

SAN MIGUEL MEDICAL CLINIC, INC. 1801992565 8204 LONG BEACH BLVD STE B SOUTH GATE 90280-2011 (323) 588-3300 12 4 7 3 10/29/1995

PALLIVATHUCAL, ROSALIND CLINICA MARIA MED CTR INC

1033244611A 8100 CALIFORNIA AVE STE K SOUTH GATE 90280-2469 (323) 357-1000 13 4 7 3 2/18/1997

SORAYA MEDICAL GROUP INC 1285782664A 2701 FIRESTONE BLVD STE W SOUTH GATE 90280-2778 (323) 249-6162 12 4 7 3 1/31/2000

MULTI HEALTH CARE MED GROUP INC 1861418576 3175 E FIRESTONE BLVD SOUTH GATE 90280-2951 (323) 567-8910 12 4 7 3 4/1/2003

SANCHEZ, DENNIS J MD SANCHEZ MEDICAL CENTER

1205859733B 3529 FIRESTONE BLVD SOUTH GATE 90280-3031 (323) 566-1700 13 4 7 3 9/2/1998

ALTAMED HEALTH SERVICES CORPORATION 1902267479 8627 ATLANTIC AVENUE SOUTH GATE 90280-3501 (888) 499-9303 22 4 7 3 7/2/2018

COMPLETE CARE COMMUNITY HEALTH CENTER INC

1811397888 5831 FIRESTONE BLVD SUITE E SOUTH GATE 90280-3718 562-806-7545 25 4 7 3 4/8/2003

BROOKDALE MEDICAL CENTER INC. 1265572903 2809 TWEEDY BLVD SOUTH GATE 90280-5538 (323) 567-9909 12 4 7 3 10/30/2006

ZARRABI MEDICAL CORP AMERICAN MEDICAL CENTER

1255323408 3175 TWEEDY BLVD SOUTH GATE 90280-5739 (323) 567-7722 12 4 7 3 7/15/1994

TWEETY FAMILY CLINIC INC 1962685966 3050 TWEETY BLVD SOUTH GATE 90280-5742 (323) 357-0700 12 4 7 3 3/17/2008

SAN MARTIN DE PORRES MED CLINIC OF SOUTH GATE INC

1134298318 10001 CALIFORNIA AVE SOUTH GATE 90280-6005 (323) 564-4408 12 4 7 3 8/14/1995

SHENOUDA, EMILE G MD INC 1538344437 10132 CALIFORNIA AVE SOUTH GATE 90280-6008 (323) 566-4411 13 4 7 3 9/30/2002

NARCISO M AZURIN MD INC / TWEEDY MEDICAL GROUP

1659479269 4075 TWEEDY BLVD SOUTH GATE 90280-6146 (323) 566-4111 12 4 7 3 1/1/1984

VENEGAS, CARLOS A MD LOYOLA MEDICAL CTR INC

1467654590 4225 TWEEDY BLVD SOUTH GATE 90280-6236 (323) 564-6464 13 4 7 3 12/11/2007

VENICE FAMILY CLINIC 1669418513 604 ROSE AVE VENICE 90291-2767 (310) 392-8636 22 4 5 3 12/18/1991

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

VENICE FAMILY CLINIC- ROBERT LEVINE FAM HEALTH

1124054564 905 VENICE BLVD VENICE 90291-4904 (310) 392-8636 22 4 5 3 6/29/2015

SOUTH BAY FAMILY HEALTH CARE 1255472924STA

323 N. PRAIRIE AVE., STE. 210 INGLEWOOD 90301 (310) 673-2647 22 4 2 3 12/22/2014

ANPHON CORPORATION 1801202676 333 E NUTWOOD STREET SUITE C INGLEWOOD 90301-2357 (310) 912-6100 25 4 8 3 7/30/2018

MONTES MEDICAL GROUP 1093809592 832 S GREVILLEA AVE INGLEWOOD 90301-3312 (310) 419-4354 12 4 8 3 2/24/1988

SOUTH BAY FAMILY HEALTHCARE CENTER-INGLEWOOD

1255472924 1091 S LA BREA AVE INGLEWOOD 90301-3817 (310) 330-2960 22 4 8 3 8/31/2005

ALBURY, DENISE A MD INC 1821411281 133 N PRAIRIE AVE STE B INGLEWOOD 90301-4879 (310) 419-2223 13 4 8 3 2/24/2009

CENTURY MEDICAL CTR APC 1528270147 3451 WEST CENTURY BLVD INGLEWOOD 90303-1218 (310) 677-9400 12 4 8 3 11/2/2004

INGLEWOOD FAMILY MEDICAL CLINIC 1750325098 3215 W IMPERIAL HWY INGLEWOOD 90303-2810 (310) 677-3595 13 4 6 3 12/2/2005

T.H.E CLINIC, INC 1023287679STA

10223 FIRMONA AVE LENNOX 90304 (323) 730-1920 22 4 8 3 4/22/2013

T.H.E. CLINIC, INC 1023287679STE

10321 HAWTHORNE BLVD INGLEWOOD 90304 (323) 730-1920 22 4 8 3 2/28/2018

CENTRAL NEIGHBORHOOD HEALTH FOUNDATION

1548610322 2710 W MANCHESTER BLVD INGLEWOOD 90305-2436 (323) 778-4310 22 4 8 3 5/24/2018

NOURMAND, AZIZ, MD 1639180623 2001 SANTA MONICA BLVD STE 865W

SANTA MONICA 90404-2128 (310) 829-3311 13 4 5 3 5/2/1990

UC REGENTS UCLA FAMILY HEALTH CENTER 1275591802 1920 COLORADO AVE SANTA MONICA 90404-3414 (310) 319-4700 12 4 5 3 6/28/2002

BENJAMIN BEHROOZAN MD INC. 1639234362 2221 LINCOLN BLVD. STE. 200 SANTA MONICA 90405-1320 (310) 396-9999 12 4 5 3 4/24/1985

VENICE FAMILY CLINIC 1558397067 2509 PICO BLVD SANTA MONICA 90405-1828 (310) 392-8636 22 4 5 3 1/22/1997

WESTSIDE FAMILY HLTH CTR 1831287978 1711 OCEAN PARK BLVD SANTA MONICA 90405-4901 (310) 450-4777 22 4 6 3 8/10/1992

CO OF L.A. - HARBOR-UCLA MEDICAL CTR 1407878150STD

21840 NORMANDIE AVE MFI 500 TORRANCE 90502 (424) 306-7270 21 4 8 3 8/25/2010

CO OF L.A. - HARBOR-UCLA PEDIATRIC PRIMARY CARE CLINIC

1407878150STA

21840 NORMANDIE AVE SUITE 350 TORRANCE 90502-2004 (424) 306-7350 1 4 8 3 9/22/1999

KEDIA, MRIDULA MD 1598860645 4201 TORRANCE BLVD. STE 380 TORRANCE 90503-4573 (310) 540-5676 13 4 8 3 6/24/1999

AIYEGBUSI AND BRAIMAH AMC 1710084959 3661 TORRANCE BLVD STE 103 TORRANCE 90503-4812 (310) 540-7240 12 4 8 3 4/1/2013

KHAN, HAMEED A MD INC 1427006113 3655 W LOMITA BLVD SUITE 421 TORRANCE 90505-1934 310-540-5464 13 4 8 3 5/19/1997

LIU, YEN-FU J MD 1598982522 3250 SEPULVEDA BLVD TORRANCE 90505-2719 (310) 534-3231 13 4 8 3 5/11/2011

NGUYEN, ANH V MD 1720205768 3250 SEPULVEDA BVLD TORRANCE 90505-2719 (310) 534-3231 12 4 8 3 4/23/2008

MEMORIALCARE MEDICAL FOUNDATION 1205167350B 22719 HAWTHORNE BLVD TORRANCE 90505-3613 (657) 241-8640 12 4 8 3 2/3/2020

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

FARFALLA INC 1750575916 3655 LOMITA BLVD. STE 211 TORRANCE 90505-3947 (310) 406-3818 13 4 8 3 3/13/2009

MONTES MEDICAL GROUP 1982873162 11822 FLORAL DR WHITTIER 90601-2900 (562) 908-4355 12 4 7 2 2/8/1985

ALI, ALIYA I MD 1962513846 12826 PHILADELPHIA ST STE A WHITTIER 90601-4127 (562) 789-8208 13 4 7 2 6/27/1996

RIO HONDO MEDICAL GROUP INC 1609972777 12444 E WASHINGTON BLVD WHITTIER 90602-1005 (562) 698-0161 13 4 7 2 4/10/1978

WHITTIER PEDIATRIC GROUP 1750463014 8522 PAINTER AVE WHITTIER 90602-3335 (562) 698-6266 12 4 7 2 6/5/2006

GHIYA, DINESH C MD 1306959333 15141 WHITTIER BLVD STE 350 WHITTIER 90603-2169 (562) 698-7761 13 4 7 2 9/2/1986

DAUER, LEONARD I MD INC 1518083856 15215 LEFFINGWELL RD WHITTIER 90604-2254 (562) 946-9696 12 4 7 2 1/27/1993

ANNIE LIM & KHENG LIM MD INC 1932299930 9209 COLIMA RD., STE 4200 WHITTIER 90605-1827 (562) 698-6388 12 4 7 2 1/14/2002

GABBITA, GEETHA V MD 1881602175 14568 WHITTIER BLVD WHITTIER 90605-2129 (562) 698-8263 13 4 7 2 5/19/1994

URGENT CARE AMERICA MEDICAL CLINIC INC 1568663573 13470 TELEGRAPH RD WHITTIER 90605-3436 (562) 906-7766 12 4 7 2 5/26/1998

INTERCOMMUNITY FAMILY MEDICAL ASSOC INC

1831251610 12291 WASHINGTON BLVD STE 500 WHITTIER 90606-2551 (562) 698-2541 12 4 7 2 10/25/2004

RAWAL, RACHNA MD INC 1295062214 14930 IMPERIAL HWY UNIT A LA MIRADA 90638-2100 (562) 906-1200 13 4 7 2 2/21/2006

ANWAR AND VASEEMA ARASTU MD INC 1831493394 12675 LA MIRADA BLVD STE 200 LA MIRADA 90638-2236 (562) 941-9853 12 4 7 2 6/28/1988

CHUANG, LILIAN SY MD 1326068354 3111 W BEVERLY BLVD MONTEBELLO 90640-2216 (323) 728-0671 13 4 7 2 9/1/1981

GONZALEZ, BERTHA A DO INC 1841477767 3106 W BEVERLY BLVD MONTEBELLO 90640-2217 323-728-1274 13 4 7 2 5/5/1999

MALAKOOTI, HAMID MD 1538243373 2428 W WHITTIER BLVD MONTEBELLO 90640-3041 (323) 722-5550 13 4 7 2 8/31/1989

KOO, HELEN S MD 1477596864 265 E BEVERLY BLVD FL 2 MONTEBELLO 90640-3776 (323) 721-4922 13 4 7 2 12/27/1984

REGULLANO, JOSE B MD 1639270051 2101 W BEVERLY BLVD STE 202 MONTEBELLO 90640-3951 (323) 888-2058 13 4 7 2 2/25/2002

YU, EDWIN T MD / REGULLANO AND YU MED GRP

1134220544 2101 W BEVERLY BLVD STE 202 MONTEBELLO 90640-3951 (323) 888-2058 13 4 7 2 2/25/2002

RAMBHATLA, SAVITRI K MD INC 1225312218 101 EAST BEVERLY BLVD STE 407 MONTEBELLO 90640-4300 323-726-6200 13 4 7 2 8/26/1992

MONTEBELLO PEDIATRIC MEDICAL GROUP 1437270014 101 E BEVERLY BLVD STE 207 MONTEBELLO 90640-4315 (323) 726-1400 12 4 7 2 7/31/1978

NARAYANAN, B MD INC 1174610380 101 E. BEVERLY BLVD STE 306 MONTEBELLO 90640-4316 (323) 888-8646 13 4 7 2 8/22/2005

WIJESEKERA, STANLEY MD 1215001987 101 E BEVERLY BLVD STE 305 MONTEBELLO 90640-4316 (323) 888-8981 13 4 7 2 8/7/1989

HETHUMUNI, STEPHANEE MD INC 1639226202 101 E BEVERLY BLVD STE 404 MONTEBELLO 90640-4317 (323) 722-6861 13 4 7 2 5/14/2008

KHAN, DEANNA Y MD 1255488821 101 E BEVERLY BLVD STE 404 MONTEBELLO 90640-4317 (323) 722-6861 13 4 7 2 5/14/2008

ADHAMI, SHAWN A MD INC 1932315827 1000 W WHITTIER BLVD MONTEBELLO 90640-4639 (323) 346-0555 12 4 7 2 10/18/2005

MODERN CONCEPTS MED GRP 1790738243 1217 W WHITTIER BLVD MONTEBELLO 90640-4642 (323) 728-6070 12 4 7 2 3/29/2011

R RUIZ MD A PROFESSIONAL 1245261023B 833 W WHITTIER BLVD MONTEBELLO 90640-4735 (323) 712-4811 12 4 7 2 8/8/2019

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

LATINO KIDS HEALTH 1457762072 901 W WHITTIER BLVD MONTEBELLO 90640-4737 323-728-8588 22 4 7 2 12/22/2014

FCS MEDICAL CORPORATION 1740233725 815 W WASHINGTON BLVD MONTEBELLO 90640-6123 (323) 728-3955 12 4 7 2 8/22/1996

SORAYA MEDICAL GROUP INC 1285782664B 11702 IMPERIAL HWY STE 110 NORWALK 90650-2890 (562) 406-8655 12 4 7 3 2/17/2000

URIBE, DANIEL MD 1922049279 13307 SAN ANTONIO DR NORWALK 90650-2970 562-807-1877 13 4 7 3 2/10/1989

SHUE, RANDALL G. DO, INC 1679576730B 11850 E. FIRESTONE BLVD NORWALK 90650-2979 (562) 281-1002 13 4 7 3 10/18/2002

JOHNSON-CHAVIS, TONI D MD, INC 1083728190B 11868 ROSECRANS AVE NORWALK 90650-3081 (562) 864-3113 13 4 7 3 9/23/2003

SHINE HEALTHCARE INC 1568760239 12371 IMPERIAL HWY NORWALK 90650-3129 (562) 929-5000 12 4 7 3 1/3/2013

MONTES MEDICAL GROUP INC 1700055746 13820 SAN ANTONIO DRIVE NORWALK 90650-4033 (562) 944-2181 12 4 7 3 3/17/2003

JWCH INSTITUTE, INC JWCH NORWALK REGIONAL

1386708634 12360 FIRESTONE BLVD NORWALK 90650-4324 (562) 281-0305 22 4 7 3 2/20/2007

SUPNET, MEDARDO C MD INC 1417069303 14359 PIONEER BLVD UNIT C NORWALK 90650-4870 (562) 406-8605 12 4 7 3 2/2/2006

SULTANA, SAYEEDA MD 1497841258A 5060 ROSEMEAD BLVD PICO RIVERA 90660-2402 (562) 942-9895 13 4 7 2 1/6/2009

SOUTHERN CALIFORNIA MEDICAL CENTER INC 1932428828 8825 WHITTIER BLVD PICO RIVERA 90660-2600 (562) 699-3333 22 4 7 2 7/7/1998

SOTOMAYOR, SALVADOR M MD 1265617393 5036 PASSONS BLVD STE 2 PICO RIVERA 90660-2864 (562) 654-2800 12 4 7 2 5/20/1998

ALTAMED HEALTH SERVICES CORP 1356775878 6336 PASSONS BLVD PICO RIVERA 90660-3355 (562) 942-3284 22 4 7 2 4/1/2019

PICO URGENT CARE AND FAMILY MEDICAL CENTER

1598794331 6632 ROSEMEAD BLVD PICO RIVERA 90660-3533 (562) 654-2828 12 4 7 2 1/2/1997

LA CLINIQUITA, INC 1679024467 6505 ROSEMEAD BLVD STE 106 PICO RIVERA 90660-3542 (562) 373-2007 13 4 7 2 7/7/2017

ALTAMED HEALTH SERVICES CORPORATION 1710191283 9436 SLAUSON AVE PICO RIVERA 90660-4748 (562) 949-6069 22 4 7 2 8/1/1991

COMMUNITY PEDIATRIC CLINIC INC 1598075442 10210 ORR AND DAY RD STE A SANTA FE SPRINGS

90670-3581 562-864-4000 13 4 7 2 9/22/2014

KIM, KUNGSOO MD 1467415455 18102 PIONEER BLVD STE 201 ARTESIA 90701-4404 (562) 865-8537 13 4 7 3 8/10/1990

WALK-IN MEDICAL CARE 1437375953 18326 PIONEER BLVD ARTESIA 90701-5533 (562) 860-5599 12 4 7 3 10/11/2007

CARIGMA, CECILIA S MD 1174719058 18821 PIONEER BLVD STE D CERRITOS 90701-5667 (562) 403-0400 13 4 7 3 12/6/2011

AVALON MEDICAL DEV CORP CENTER 1346250347 100 FALLS CANYON ROAD AVALON 90704-1563 (310) 510-0700 22 4 8 3 8/21/1991

CO OF L.A. - BELLFLOWER HEALTH CENTER 1518973940 10005 E FLOWER STREET BELLFLOWER 90706-0000 (562) 526-3000 21 4 7 3 6/26/2002

WONG, HANSON P MD 1073725768 10230 ARTESIA BLVD STE 201 BELLFLOWER 90706-2564 (562) 804-7223 12 4 7 3 5/18/1998

JWCH INSTITUTE INC 1538342704 14371 CLARK AVENUE BELLFLOWER 90706-2901 562-867-7999 22 4 7 3 10/2/2012

SANCHEZ, DENNIS J MD SANCHEZ MEDICAL CENTER

1205859733A 9306 ALONDRA BLVD BELLFLOWER 90706-4212 (562) 866-9100 13 4 7 3 10/2/2003

PANGANIBAN, VIRGILIO C MD INC 1144475898 16704 CLARK AVE BELLFLOWER 90706-5204 (562) 925-7033 13 4 7 3 6/10/1998

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

CENTURY FAMILY MEDICAL GROUP INC 1558703017 16900 LAKEWOOD BLVD SUITE 308 BELLFLOWER 90706-5580 562-991-1900 12 4 7 3 3/27/2015

YUJUICO-DANGANAN, IMELDA MD INC 1255401139 16904 BELLFLOWER BLVD BELLFLOWER 90706-5904 (562) 866-8046 13 4 7 3 11/30/2001

NGUYEN, DAVID D MD INC 1669553236 9817 ARKANSAS ST BELLFLOWER 90706-5913 (562) 867-8881 12 4 7 3 11/17/2003

THE CHILDRENS CLINIC SERVING CHILDREN AND THEIR

1447556170 17660 LAKEWOOD BLVD BELLFLOWER 90706-6410 (562) 264-4827 25 4 7 3 8/9/2012

SALAZAR, TERESITA MD INC 1710159223 17403 WOODRUFF AVE BELLFLOWER 90706-6746 (562) 804-0742 12 4 7 3 9/4/2003

PAMARAN, MARIA V MD 1003913831 10230 ARTESIA BLVD STE 302 BELLFLOWER 90706-6769 (562) 461-7588 13 4 7 3 6/9/1999

SANCHEZ-BAL, VICTORIA MD FAAP INC 1548526445 9604 E ARTESIA BLVD SUITE 202 BELLFLOWER 90706-8039 562-965-2625 13 4 7 3 5/19/1987

CO OF L.A. - HARBOR-UCLA MEDICAL CTR - FAMILY MEDICINE CLINIC

1407878150STB

1403 W LOMITA BLVD 2ND FLOOR HARBOR CITY 90710-0000 (310) 602-2600 1 4 8 3 11/21/1991

ST ISABEL FAMILY MEDICAL CLINIC, INC 1700057981 1535 W LOMITA BLVD HARBOR CITY 90710-2024 (310) 530-9300 12 4 8 3 2/18/2009

NORTHEAST COMMUNITY CLINICS 1952641136 1403 LOMITA BLVD STE 100, 101, 106

HARBOR CITY 90710-2084 (310) 784-5800 22 4 8 3 12/18/2013

NORTHEAST COMMUNITY CLINICS INTERMITTENT

1124460274STB

1403 W LOMITA BLVD STE 103 HARBOR CITY 90710-2084 (310) 784-1800 22 4 8 3 12/27/2016

RODRIGUEZ, EVA B MD INC 1639266141 1403 LOMITA BLVD STE 305 HARBOR CITY 90710-2085 (310) 325-4344 13 4 8 3 9/23/2010

MENDOZA, JOSE E MD 1588712541 5750 DOWNEY AVE STE 204 LAKEWOOD 90712-1472 (562) 531-4362 13 4 7 3 4/22/1983

DAHIYA SHYAM L MD INC 1306039300 3650 SOUTH ST STE 412 LAKEWOOD 90712-1500 (562) 602-1012 12 4 6 3 11/18/2008

SEDRAK, BOTHYNA F MD 1750472965 3650 SOUTH ST STE 209 LAKEWOOD 90712-1526 (562) 634-1254 13 4 7 3 3/24/1983

AGUILUZ, JACQUELINE B DO TOWNE CENTER FAMILY MED

1851306724 21508 NORWALK BLVD HAWAIIAN GARDENS

90716-1122 (562) 865-5214 13 4 7 3 8/31/2004

PROHEALTH PARTNERS A MEDICAL GROUP 1730519927 12131 CARSON ST HAWAIIAN GARDENS

90716-1154 562-809-0299 12 4 7 3 11/8/2016

FAMILY PLANNING CENTER HAWAIIAN GARDENS HLTH CT

1811032436 22310 WARDHAM AVE HAWAIIAN GARDENS

90716-1740 (562) 928-9600 22 4 7 3 9/22/2006

QAZI, SHAGUFTA MD INC 1326216599 2173 LOMITA BLVD STE 105 LOMITA 90717-1636 (424) 305-4169 13 4 8 3 9/28/2009

ITCHON, LIDEIA N MD INC 1336240217 25835 NARBONNE AVE STE 260 LOMITA 90717-3085 (310) 517-0977 13 4 8 3 3/23/2004

MEDICAL GRP OF PARAMOUNT / CLINICA MEDICA HISPANA

1972563617 14906 PARAMOUNT BLVD. PARAMOUNT 90723-3409 (562) 630-1991 12 4 6 3 6/1/1994

CONSULTORIO MEDICO LATINO MEDICAL CENTER

1518996313 15730 PARAMOUNT BLVD PARAMOUNT 90723-4333 (562) 634-1000 12 4 6 3 2/9/1996

JORGE, CAMILO S MD INC 1740511369 16415 COLORADO AVE STE 102 PARAMOUNT 90723-5051 (562) 531-1946 13 4 6 3 1/27/1999

ADVANCED FAMILY MEDICAL GRP 1588778930 16415 COLORADO AVE STE 304 PARAMOUNT 90723-5053 (562) 531-4171 13 4 6 3 9/28/1978

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

REY-MONROY, MA MILDRED MD INC 1295003085 16415 COLORADO AVE STE 308 PARAMOUNT 90723-5053 562-630-5581 12 4 6 3 12/22/1988

CLINICA MEDICA LA SAGRADA FAMILIA 1578567038 15955 PARAMOUNT BLVD STE A PARAMOUNT 90723-5113 (562) 531-9806 12 4 6 3 5/16/1995

PARA LATINO MEDICAL CENTER INC 1356498935 15717 PARAMOUNT BLVD. PARAMOUNT 90723-5113 (562) 531-2231 13 4 6 3 7/23/2001

COMMUNITY MEDICINE, INC 1457744476 8540 ALONDRA BLVD SUITE B-2 PARAMOUNT 90723-5200 (562) 602-2508 25 4 6 3 9/6/2017

MERCY MEDICAL CENTER 1104014414 16444 PARAMOUNT BLVD STE 103 PARAMOUNT 90723-5453 (562) 531-7790 12 4 6 3 7/26/1993

MANGUNE, FLORENCIA M MD 1467559542 16660 PARAMOUNT BLVD # 110 PARAMOUNT 90723-5457 (562) 633-2021 13 4 6 3 10/15/1991

GODOY, IGNATIUS P MD INC 1972789188 16660 PARAMOUNT BLVD STE 206 PARAMOUNT 90723-5458 (562) 634-9433 12 4 6 3 10/14/1997

J AND L DE LEON MEDICAL CORPORATION 1760407621 16660 PARAMOUNT BLVD., STE 211 PARAMOUNT 90723-5469 (562) 633-5438 12 4 6 3 6/22/2005

SAN PEDRO PEDIATRIC MED GRP 1255446142 1294 W. 6TH ST, STE 102 SAN PEDRO 90731-2997 (310) 832-6487 12 4 8 3 8/4/1995

HANNA, HANAA MD INC 1811342751 887 W 9TH ST SAN PEDRO 90731-3603 310-547-0888 13 4 8 3 4/28/2008

HARBOR FREE CLINIC 1467653873 731 S BEACON ST SAN PEDRO 90731-3738 310-732-5887 22 4 8 3 4/4/2006

KRIEGER, LORI R MD 1881632925 1360 W 6TH ST STE 300 SAN PEDRO 90732-3576 (310) 514-0838 13 4 8 3 7/1/2001

COMPLETE CARE FAMILY MEDICAL CLINIC, APC 1871645184 1231 N AVALON BLVD WILMINGTON 90744-2601 (310) 835-5000 12 4 8 3 6/1/1999

CO OF L.A. - WILMINGTON SUBCENTER 1508872912 1325 BROAD AVE. WILMINGTON 90744-2604 (310) 404-2040 22 4 6 3 3/20/2006

TOTAL CARE MEDICAL CLINIC INC 1801154463 1110 W ANAHEIM ST STE 6 WILMINGTON 90744-4131 310-872-3560 25 4 8 3 12/22/2014

COMFORT FAMILY CLINIC INC 1538500798 215 W ANAHEIM STREET WILMINGTON 90744-4418 310-816-3111 12 4 8 3 2/27/2015

WILMINGTON COMMUNITY CLN 1932194586 1009 N AVALON BLVD WILMINGTON 90744-4505 (310) 549-5760 22 4 8 3 8/16/2004

THE NORTHEAST COMMUNITY CLNC 1700097540A 200 E ANAHEIM STREET WILMINGTON 90744-4516 (310) 522-8700 22 4 8 3 2/12/2007

MOLINA, JOSEPH M MD PROFESSIONAL CORPORATION

1982976692 445 E ANAHEIM STREET #H WILMINGTON 90744-4600 (310) 518-6146 12 4 8 3 8/16/1985

SEA BREEZE HEALTH CENTER INC 1750541322 123 EAST F ST UNIT F WILMINGTON 90744-5817 (310) 830-6500 13 4 8 3 4/21/2006

SOUTH BAY FAMILY HEALTH CARE 1871933945 270 E 223RD STREET CARSON 90745-3804 (310) 221-6800 22 4 8 3 5/27/2014

TAMHANE, SHRIKANT K DO CLINIC 1497868251 23517 SOUTH MAIN STREET STE 103

CARSON 90745-4953 310-834-5388 13 4 8 3 1/12/2009

DIEGO MEDICAL CORPORATION 1225060643 23517 S. MAIN STREET SUITE 101 CARSON 90745-5227 (310) 549-2840 13 4 8 3 5/19/1978

ROXAS-BUTLIG, EVANGELINE MD 1225366305 1000 E DOMINGUEZ ST STE 110 CARSON 90746-3600 (310) 715-7755 13 4 8 3 11/30/2005

LEE, KIT H MD 1518015916 3300 E SOUTH ST STE 204 LAKEWOOD 90805-4634 (562) 602-1733 13 4 7 3 3/5/1984

OSIBAMIRO, ADE MD INC 1073547220 2637 E CARSON STREET CARSON 90810-1508 (310) 847-1321 13 4 8 3 5/27/2014

CO OF L.A. - LONG BEACH CHC 1518971241 1333 CHESTNUT AVENUE LONG BEACH 90813-2944 (562) 753-2301 21 4 8 3 4/29/1987

MAKENA HEALTHCARE CORP 1538525787 622 W DUARTE ROAD STE 301 ARCADIA 91007-9277 626-461-5883 13 4 3 2 5/16/2016

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

TADROS, GEORGETTE MD 1598869018 931 BUENA VISTA ST STE 202 DUARTE 91010-1713 (626) 301-1515 13 4 3 2 11/7/1989

KOLDHEKAR, VAIJAYANTI MD INC 1386730919 931 BUENA VISTA STREET 302 DUARTE 91010-1714 (626) 303-2541 13 4 3 2 9/14/2005

CUENTO, ALICIA MD INC 1073880167 931 BUENA VISTA ST STE 100 DUARTE 91010-1780 (626) 357-5087 12 4 3 2 4/16/1981

CHILDREN FIRST PEDIATRIC GROUP OF DUARTE, A MEDIC

1295935203 2329 E HUNTINGTON DR DUARTE 91010-2102 (626) 357-4600 12 4 3 2 4/25/2003

YBPC MEDICAL CLINIC INC 1760689426B 1750 HUNTINGTON DR STE B DUARTE 91010-2136 (626) 930-1600 12 4 3 2 3/11/2010

DE SILVA, JANESRI MD APC 1326278490F 1442 FOOTHILL BLVD LA CANADA 91011-2107 (818) 361-5437 12 4 2 1 11/21/2018

COMMUNITY HEALTH ALLIANCE OF PASADENA 1063805463 513 E LIME AVENUE SUITE 101 AND 102

MONROVIA 91016-2982 (626) 788-0290 25 4 3 2 6/6/2017

ALL FOR HEALTH HEALTH FOR ALL 1760900922 2048 MONTROSE AVE MONTROSE 91020 (818) 957-2224 22 4 2 1 11/21/2018

COMPREHENSIVE COMMUNITY HEALTH CENTERS INC

1972954071 8316 FOOTHILL BLVD SUNLAND 91040-2850 (818) 273-8800 22 4 2 1 11/1/2017

BALTAIAN, LILIT MD INC 1508109794 7412 FOOTHILL BLVD TUJUNGA 91042-2722 (818) 353-1512 13 4 2 1 3/19/2012

SIMONIAN, NUNE A MD 1205967916 435 W ARDEN AVE STE 550 GLENDALE 91203-4026 (818) 242-3916 13 4 2 1 4/7/1999

AINTABLIAN, IGHIA MD APC 1750770608 1510 SOUTH CENTRAL AVE SUITE 450

GLENDALE 91204-2510 (818) 500-8822 13 4 2 2 8/25/1989

ABRAHAM, GIZEL A MD 1033144704 1510 S CENTRAL AVE STE 510 GLENDALE 91204-2543 (818) 502-2181 13 4 2 2 5/6/1999

KAAKIJIAN, SARKIS A MD INC 1992801906 1500 S CENTRAL AVE STE 318 GLENDALE 91204-2574 (818) 548-5437 13 4 2 2 12/12/1996

LUNA, LELANIE M MD INC 1427195387 1500 S CENTRAL AVE STE 310 GLENDALE 91204-2581 (818) 500-1331 12 4 2 2 4/14/1999

DEBNATH, SHEILA MD INC 1952625303 1220 S CENTRAL AVE STE 105 GLENDALE 91204-3808 (818) 545-9539 13 4 2 2 2/3/1995

ALL FOR HEALTH HEALTH FOR ALL INC 1518398031 1030 SOUTH GLENDALE AVE SUITE 307

GLENDALE 91205-2866 818-839-4160 22 4 2 1 3/14/2012

CHARCHIAN MEDICAL CORP 1396962460 1030 S GLENDALE AVE STE 305 GLENDALE 91205-2866 (818) 241-0220 12 4 2 1 8/22/1997

WHOLE FAMILY HEALTH, PC 1346557691 1030 S GLENDALE AVE STE 200 GLENDALE 91205-2866 (818) 850-5667 13 4 2 1 3/2/2016

COMPREHENSIVE COMMUNITY HEALTH CENTERS GLENDALE

1356362743 801 S CHEVY CHASE DR STE 250 GLENDALE 91205-4433 (818) 265-2264 22 4 2 1 9/12/2007

FAMILY PRACTICE OF GLENDALE A MEDICAL CORPORATION

1801851043A 801 S CHEVY CHASE DR STE 230 GLENDALE 91205-4436 (818) 500-5586 12 4 2 1 1/1/1990

CHAN, CHOA MD INC 1992831671 1530 E CHEVY CHASE DR STE 202 GLENDALE 91206-4139 (818) 244-9595 13 4 2 1 3/8/2002

FAMILY PRACTICE OF GLENDALE A MEDICAL CORPORATION

1801851043B 1818 VERDUGO BLVD STE 200 GLENDALE 91208-1437 (818) 790-1088 12 4 2 1 6/11/2003

ROY MEDICAL GROUP INC 1801921952B 21001 SHERMAN WAY STE 15 CANOGA PARK 91303-1760 (818) 716-0048 12 4 2 1 3/25/1997

BENDITO PEDIATRICS, INC 1144596966 22030 SHERMAN WAY STE 210 CANOGA PARK 91303-1855 (818) 857-5991 13 4 2 1 1/23/2013

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

NGUYEN, TUAN HUU MD 1073607446 22030 SHERMAN WAY STE 211 CANOGA PARK 91303-1882 (818) 884-7424 13 4 2 1 5/27/1981

NORTHEAST VALLEY HEALTH LAC-CANOGA PARK

1740281120 7107 REMMET AVE CANOGA PARK 91303-2016 (818) 340-3570 22 4 2 1 10/1/1996

FLORENCE WESTERN MEDICAL CLINIC INC 1437495462 20440 SHERMAN WAY CANOGA PARK 91306 (818) 346-2395 12 4 2 1 9/27/2013

EL PROYECTO DEL BARRIO INC WINNETKA CLINIC

1538130893 20800 SHERMAN WAY WINNETKA 91306-2707 (818) 883-2273 22 4 2 1 3/22/2000

HEKMAT, VAHID MD INC 1124416607 23101 SHERMAN PLACE STE 407 WEST HILLS 91307-2032 818-999-3800 13 4 2 1 11/3/2011

ZAFARANCHI, MOJDEH MD INC 1861823247 23644 VANOWEN ST WEST HILLS 91307-2443 818-887-5515 13 4 2 1 8/19/1993

DE SILVA, JANESRI MD APC 1326278490G 17609 VENTURA BLVD STE 106 ENCINO 91316-3866 (818) 361-5437 12 4 2 1 11/21/2018

SHAHEEDY, MOHAMAD MD 1699855098 5400 BALBOA BLVD STE 210 ENCINO 91316-5208 (818) 501-7111 13 4 2 1 7/29/1983

LAKESIDE MEDICAL 1831426642C 24355 LYONS AVENUE SUITE 210 SANTA CLARITA 91321-2381 (661) 222-9381 12 4 2 1 4/21/2014

SAMUEL DIXON FAMILY 1154402675C 23772 NEWHALL AVE NEWHALL 91321-3125 (661) 291-1777 22 4 2 1 11/22/2011

DE SILVA, JANESRI MD APC 1326278490D 8940 RESEDA BLVD STE 101 NORTHRIDGE 91324 (818) 361-5437 13 4 2 1 5/25/2011

TARZANA TREATMENT CENTER FAMILY MEDICAL CLINIC

1427043389 8330 RESEDA BLVD NORTHRIDGE 91324-4619 818-996-1051 25 4 2 1 8/22/2002

FARROHI, FAREADEH MD 1669487435 18546 ROSCOE BLVD STE 211 NORTHRIDGE 91324-5451 (818) 885-8040 13 4 2 1 11/29/2000

VASQUEZ, JULIO N MD INC A PROFESIONAL CORP

1467612820 8540 RESEDA BLVD., SUITE 240 NORTHRIDGE 91324-6142 818-772-7023 13 4 2 1 3/3/2009

DIGNITY HEALTH MEDICAL FOUNDATION 1508222647 18406 ROSCOE BLVD NORTHRIDGE 91325-4107 (818) 885-5480 12 4 2 1 1/27/1978

TROMPETA, BELLAFLOR V MD A MEDICAL CORP

1922137272 18433 ROSCOE BLVD STE 104 NORTHRIDGE 91325-4127 (818) 993-9555 13 4 2 1 3/29/1980

SACHANI, MEHBOOB A MD 1144268657 18350 ROSCOE BLVD STE 205 NORTHRIDGE 91325-4150 (818) 993-0506 13 4 2 1 3/31/1982

EL PROYECTO DEL BARRIO INC 1093181448 18250 ROSCOE BLVD SUITE 200 NORTHRIDGE 91325-4226 (818) 721-4800 22 4 2 1 1/29/2018

KAYEKJIAN, GARABED MD INC 1306026034 18250 ROSCOE BLVD STE 130 NORTHRIDGE 91325-4264 (818) 998-8097 13 4 2 1 11/18/1997

SAN DIEGO, ROSITA D MD 1467652602 9043 WOODMAN AVENUE STE C ARLETA 91331 (818) 786-8601 13 4 2 1 11/6/2008

NORTHEAST VALLEY HEALTH 1114928595 12756 VAN NUYS BLVD PACOIMA 91331-1696 (818) 896-0531 22 4 2 1 1/1/1992

FLORENCE WESTERN MEDICAL CLINIC INC 1376888024 13500 VAN NUYS BLVD PACOIMA 91331-3028 (818) 896-2999 12 4 2 1 8/29/2013

LAUREL MEDICAL CENTER INC 1144368887 13680 VAN NUYS BLVD PACOIMA 91331-3616 (818) 897-7730 12 4 2 1 10/4/1996

DE SILVA, JANESRI MD APC 1326278490E 13711 VAN NUYS BLVD STE 1 -2 PACOIMA 91331-3638 818-901-1600 12 4 2 1 1/13/2015

EL PROYECTO DEL BARRIO FAMILY HEALTH CARE CLIN

1083624423 8902 WOODMAN AVE STE 2 ARLETA 91331-6401 (818) 830-7033 22 4 2 1 8/1/1992

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

NOURI, JAHANBAKHSH MD WOODMAN MEDICAL AND DENTAL

1366501629 8725 WOODMAN AVE ARLETA 91331-6560 (818) 891-4455 13 4 2 1 12/17/1997

UNIVERSAL MEDICAL CLINIC, INC 1760671077 18040 SHERMAN WAY STE 310 RESEDA 91335 (818) 881-8989 12 4 2 1 7/29/2008

NGUYEN, HUNG V MD 1104819945 7227 RESEDA BLVD RESEDA 91335-3046 (818) 708-7227 13 4 2 1 9/23/1988

FACEY MEDICAL FOUNDATION 1710031588H 18133 VENTURA BLVD 204 AND 402 TARZANA 91335-3612 (818) 466-7700 4 2 1 12/6/2016

KIM, JUNG H MD 1902914773 18614 SHERMAN WAY RESEDA 91335-4138 (818) 996-9497 13 4 2 1 8/18/1983

CISCO MEDICAL GROUP INC 1053408989 18518 SHERMAN WAY RESEDA 91335-4212 (818) 757-0954 12 4 2 1 4/5/2007

KASHANI, ATAOLAH MD/RESEDA MED CL 1740349851 18355 SHERMAN WAY RESEDA 91335-4436 (818) 343-0964 13 4 2 1 11/4/1997

NOBEL CARE MEDICAL GROUP INC /SAN FERNANDO MED CTR

1093933939 501 NORTH MACLAY AVE SAN FERNANDO 91340-2424 (818) 361-3788 13 4 2 1 9/17/2002

VALLEY MISSION MEDICAL A MEDICAL CORPORATION

1942343785 220 N MACLAY AVE STE 2 SAN FERNANDO 91340-2909 (818) 837-1355 12 4 2 1 10/22/1994

NORTHEAST VALLEY HEALTH 1235130600 1600 SAN FERNANDO RD SAN FERNANDO 91340-3115 (818) 365-8086 22 4 2 1 5/14/1992

CO OF L.A. - SAN FERNANDO HEALTH CTR 1558379990 1212 PICO ST SAN FERNANDO 91340-3503 (818) 627-4777 22 4 2 1 12/29/2005

SAN FERNANDO COMMUNITY HOSPITAL 1245669555 732 MOTT STREET SUITE 100 AND 110

SAN FERNANDO 91340-4240 (818) 963-5690 22 4 2 1 3/10/2016

NORTHEAST VALLEY HEALTH CORPORATION 1417958943 11051 N O' MELVENY AVE SAN FERNANDO 91340-4426 (818) 365-7517 22 4 2 1 5/14/1992

CO OF L.A. - OLIVE VIEW- UCLA MED. CTR. 1316969934STA

14445 OLIVE VIEW DRIVE SYLMAR 91342-1437 (747) 210-3233 22 4 2 1 7/30/2019

CO OF L.A. - OLIVE VIEW -UCLA MED. CTR.- PEDIATRICS

1316969934 14445 OLIVE VIEW DR. SYLMAR 91342-1437 (747) 210-3144 22 4 2 1 11/19/1975

VALLEY COMMUNITY HEALTHCARE APCC 1932501996 9119 HASKELL AVENUE NORTH HILLS 91343-3114 (818) 763-8836 22 4 2 1 11/19/2015

HEALTH CARE ANGELS MEDICAL CLINIC INC 1720269194 9146 SEPULVEDA BLVD NORTH HILLS 91343-6948 (818) 920-1133 13 4 2 1 7/20/1999

EZRA, ESHAGH MD INC 1790797835 15424 NORDHOFF ST SUITE B NORTH HILLS 91343-6952 (818) 891-5500 13 4 2 1 10/15/2007

CHOICE PROVIDERS MEDICAL GROUP INC 1114947058B 17709 CHATSWORTH ST GRANADA HILLS 91344-5675 (818) 363-8176 12 4 2 1 1/29/2007

SHOHAM, STEVEN C MD 1841290400 10515 BALBOA BLVD STE 360 GRANADA HILLS 91344-6346 (818) 832-3322 13 4 2 1 12/15/1989

VALLEY PEDIATRICS APMC/PREMIER PEDIATRICS MED

1043423460 14901 RINALDI ST STE 330 MISSION HILLS 91345-1251 (818) 365-7778 12 4 2 1 9/11/2002

ALL VALLEY PEDIATRICS INC 1942219167 14901 RINALDI ST STE 300 MISSION HILLS 91345-1255 (818) 365-7783 12 4 2 1 12/4/2003

SHENOUDA, EMILE G MD INC 1437334331 15340 DEVONSHIRE ST STE 8 MISSION HILLS 91345-2760 (818) 894-9411 13 4 2 1 11/29/2000

NORTHEAST VALLEY HEALTH 1558693655 18533 SOLEDAD CANYON RD SANTA CLARITA 91351-3722 (661) 673-8800 22 4 2 1 10/21/2010

VASHISTHA, KRISHAN K MD 1629062005 27141 HIDAWAY AVE STE 105 CANYON COUNTRY 91351-4137 (661) 251-4783 13 4 2 1 5/13/1983

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

NAT, NARINDAR K MD 1255393682 27141 HIDAWAY AVE SUITE 200 CANYON COUNTRY 91351-4144 (661) 251-8400 13 4 2 1 4/2/2007

SERRA COMMUNITY MEDICAL CLINIC 1275545725 9375 SAN FERNANDO RD SUN VALLEY 91352-1418 (818) 768-3000 12 4 2 1 4/19/2001

NORTHEAST VALLEY HEALTH CORP SUN VALLEY HEALTH CENTER

1013199264 7223 FAIR AVE SUN VALLEY 91352-4964 (818) 432-4400 22 4 2 1 3/14/2008

NORTHEAST VALLEY HEALTH LAC-VALENCIA 1730180118 23763 VALENCIA BLVD VALENCIA 91355-2105 (661) 287-1551 22 4 2 1 10/4/1996

NORTHEAST VALLEY HEALTH CORPORATION 1881104313 23413 LYONS AVE SANTA CLARITA 91355-3028 (661) 593-7500 22 4 2 1 4/12/2018

MINASSIAN, GUIRAGOS MD 1871681817A 18372 CLARK ST STE 226 TARZANA 91356-3557 (818) 708-8044 13 4 2 1 11/22/2000

BURSTEIN MD PROFESSIONAL CORPORATION 1093808933A 6325 TOPANGA CANYON BLVD STE 224

WOODLAND HILLS 91367 (818) 222-2443 13 4 2 1 7/21/2005

SAMUEL DIXON FAMILY HEALTH CENTER 1154402675A 30257 SAN MARTINEZ RD VAL VERDE 91384-2472 (661) 257-4008 22 4 2 1 2/1/1991

FELDMAN, ROCHELLE C MD 1053368167 18520 VIA PRINCESSA STE C2 CANYON CNTRY 91387-8326 (661) 424-9000 13 4 2 1 5/19/2008

DE SILVA, JANESRI MD APC 1326278490A 14426 GILMORE AVENUE UNIT B VAN NUYS 91401 (818) 361-5437 13 4 2 1 1/15/2010

THE VALLEY CLINICA MEDICA GENERAL, MED CNTR

1962459479 6511 VAN NUYS BLVD VAN NUYS 91401-1425 (818) 901-9090 12 4 2 1 3/9/2012

VALLEY MISSION MEDICAL A MED CORPORATION

1699818278 6410 VAN NUYS BLVD STE B VAN NUYS 91401-1449 (818) 908-2300 12 4 2 1 10/17/1997

MAROUNI, PAYAM MD INC 1114255437 13750 VICTORY BLVD VAN NUYS 91401-2324 (818) 988-9090 12 4 2 1 3/13/2013

YASHARPOUR MEDICAL DOCTOR, INC APMC 1255849238 6330 VAN NUYS BLVD VAN NUYS 91401-2610 (818) 994-9822 12 4 2 1 6/7/2019

PEDIATRIC AND FAMILY MEDICAL CENTER 1982075115STA

15253 ROSCOE BLVD PANORAMA CITY 91402 (818) 920-9947 25 4 2 1 6/8/2017

CENTER FOR FAMILY HEALTH AND EDUCATION INC

1871853481 8727 VAN NUYS BLVD STE 102 AND 203

PANORAMA CITY 91402-2400 818-899-5555 22 4 2 1 8/23/1999

MICHAEL, MAHFOUZ M MD / CLINICA MED SAN MIGUEL

1881627057 8781 VAN NUYS BLVD. PANORAMA CITY 91402-2406 (818) 892-8349 12 4 2 1 4/22/1998

SANTO NINO MEDICAL CLINIC 1770685612 14427 CHASE ST STE 100 PANORAMA CITY 91402-3020 (818) 830-7751 12 4 2 1 5/29/2003

MARIA LILIBETH T SY MD INC 1609969997 8162 VAN NUYS BLVD PANORAMA CITY 91402-4806 (818) 787-5800 12 4 2 1 9/14/2005

LANARK FAMILY MED CLINIC 1124106646 8040 VAN NUYS BLVD PANORAMA CITY 91402-6010 (818) 373-4870 12 4 2 1 11/14/2003

EL PROYECTO DEL BARRIO INC 1568871143 9140 VAN NUYS BLVD SUITE 207 PANORAMA CITY 91402-6763 (818) 830-7181 22 4 2 1 6/9/2017

PEDIATRIC AND FAMILY MEDICAL CENTER 1982075107 15477 VENTURA BLVD SUITE 300 SHERMAN OAKS 91403-3006 (818) 907-0322 22 4 2 1 6/8/2017

CO OF L.A. - MID VALLEY COMP HC 1467465641STA

7515 VAN NUYS BLVD VAN NUYS 91405-1949 (818) 627-3000 22 4 2 1 12/30/2005

CO OF L.A. - MID VALLEY COMP HLTH CTR 1467465641 7515 VAN NUYS BLVD VAN NUYS 91405-1949 (818) 627-3000 22 4 2 1 12/30/2005

YASHARPOUR MEDICAL DOCTOR, INC., APMC 1316455363 7400 VAN NUYS BLVD., STE 120 VAN NUYS 91405-1972 (818) 782-9892 12 4 2 1 7/1/2019

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

AZADI-RAD, AYAT MD 1154593929 7232 VAN NUYS BLVD STE 201 VAN NUYS 91405-2231 (818) 373-4999 13 4 2 1 11/1/2010

MOGHADAM, MEHDI A MD 1679625222 7232 VAN NUYS BLVD STE 201 VAN NUYS 91405-2231 (818) 373-4999 13 4 2 1 12/11/2001

PECKSON, LOUELLA MD INC 1144516295 14624 SHERMAN WAY SUITE 401 VAN NUYS 91405-2289 (818) 786-1200 13 4 2 1 2/27/2002

NORTHEAST VALLEY HEALTH PEDIATRIC HLTH & WIC CTR

1093716474 7138 VAN NUYS BLVD VAN NUYS 91405-3005 (818) 778-6240 22 4 2 1 8/1/2000

TOOMARI, TAJAV DO INC 1871880500 7100 VAN NUYS BLVD STE 110 VAN NUYS 91405-3063 (818) 205-1666 13 4 2 1 6/4/2012

KIM, KYU HYUN MD INC 1114007754 15243 VANOWEN ST STE 300 VAN NUYS 91405-3605 818-786-4910 13 4 2 1 8/29/1995

PEDIATRIC AND FAMILY MEDICAL CENTER 1982075115 6618 VAN NUYS BLVD VAN NUYS 91405-4617 (818) 908-9962 22 4 2 1 5/11/2017

LAVIAN, DAVID MD INC 1285931105 14600 SHERMAN WAY STE 215 VAN NUYS 91405-5050 (818) 782-4300 13 4 2 1 11/10/1999

ROY MEDICAL GROUP INC 1801921952A 16063 VANOWEN ST VAN NUYS 91406-4810 (818) 785-9989 12 4 2 1 3/25/1997

CLINICA MEDICA ABC 1518161629 14649 VICTORY BLVD STE 20 VAN NUYS 91411 (818) 786-8396 13 4 2 1 8/24/2009

SOUTHERN CALIFORNIA MEDICAL CENTER INC 1255729661 14550 HAYNES ST VAN NUYS 91411-1613 (818) 650-6700 22 4 2 1 8/29/2017

RAM, ASHER MD CENTRO MEDICO FAMILIAR 1609803733 14547 VICTORY BLVD VAN NUYS 91411-1619 (818) 997-3232 13 4 2 1 4/30/1990

HAKIMIAN, EBRAHIM MD 1568481174 14649 VICTORY BLVD STE 22 VAN NUYS 91411-4101 (818) 909-9868 13 4 2 1 8/8/1996

TOOMARI, TAJAV DO INC 1326372830 16661 VENTURA BLVD STE 408 ENCINO 91436-1914 (818) 205-1666 13 4 2 1 2/15/2011

ALL INCLUSIVE COMMUNITY HLTH 1093019051 1311 N. SAN FERNANDO BLVD BURBANK 91504-4236 (818) 843-9900 22 4 2 1 1/2/2015

BEHMANESH, BEHZAD MD 1194801167 2701 W ALAMEDA AVE SUITE 604 BURBANK 91505-4411 818-845-5000 13 4 2 1 3/27/2015

ROY MEDICAL GROUP INC 1801921952E 8001 LAUREL CANYON BLVD STE 109

NORTH HOLLYWOOD

91605-1400 818-767-4728 12 4 2 1 11/14/2016

MOAS, OVI MD / CLINICA MED INTER MD CTR 1427123504 7444 LANKERSHIM BLVD NORTH HOLLYWOOD

91605-2801 (818) 765-4917 13 4 2 1 2/1/1996

AAA COMPREHENSIVE HEALTHCARE 1396067500 7451 N LANKERSHIM BLVD NORTH HOLLYWOOD

91605-2803 (818) 503-9800 22 4 2 1 10/21/2010

VALLEY COMMUNITY HEALTHCARE 1588740989 6801 COLDWATER CANYON AVE N HOLLYWOOD 91605-5162 (818) 763-8836 22 4 2 1 8/1/2002

COMPREHENSIVE COMMUNITY HEALTH CTR-NO HOLLYWOOD

1871573360 12157 VICTORY BLVD N HOLLYWOOD 91606-3204 (818) 755-8000 22 4 2 1 7/20/2004

CHOICE PROVIDERS MEDICAL GROUP 1114947058C 11631 VICTORY BLVD STE 101 N HOLLYWOOD 91606-3572 (818) 764-8838 12 4 2 1 8/20/2007

DAYANI, JILA MD 1730265703 12626 RIVERSIDE DR STE 101 N HOLLYWOOD 91607-3448 (818) 766-7640 13 4 2 1 12/12/1996

PUEBLO MEDICAL ASSOCIATE 1407033277 521 N AZUSA AVE AZUSA 91702-2936 (626) 334-4061 12 4 3 2 8/26/2008

EL PROYECTO DEL BARRIO INC AZUSA CLINIC 1770696023 150 N AZUSA AVE AZUSA 91702-3521 (626) 969-7885 22 4 7 2 6/25/2007

SHALABI, KAIED O MD SHALABI MEDICAL CLINIC

1598857815 453 E ARROW HWY STE B AZUSA 91702-5612 (626) 915-1748 13 4 3 2 6/23/1987

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

FOOTHILL COMMUNITY MED CORP/SAN RAFAEL COMM MED

1881811404 647 E ARROW HWY AZUSA 91702-5802 (626) 858-5199 12 4 3 2 2/6/2002

BERGANZA, JOSE D MD INC SAN JOSE MULTISPECIALTY

1962560896 14514 RAMONA BLVD SUITE 3 BALDWIN PARK 91706-3361 (626) 337-0424 12 4 3 2 2/20/1998

EL PROYECTO DEL BARRIO INC 1154730828 3942 MAINE AVE BALDWIN PARK 91706-4220 626-678-9296 22 4 3 2 2/22/2016

BALDWIN PARK MEDICAL CLINIC INC. 1750728663 14135 FRANCISQUITO AVE STE 106 BALDWIN PARK 91706-5010 626-960-3753 13 4 3 2 10/22/2014

CENTRAL CITY COMMUNITY HEALTH CENTER INC

1669881926 4126 N MAINE AVE BALDWIN PARK 91706-5010 626-653-0800 22 4 3 2 6/12/2017

PREMIER FAMILY MEDICINE ASSOCIATES, INC 1164668786 1601 N MONTE VISTA AVE STE 100 CLAREMONT 91711-6601 (909) 630-7938 12 4 3 2 11/14/2011

GIDOWSKI, ROSA M MD 1689742702 368 W BADILLO ST COVINA 91723-1827 (626) 915-5161 13 4 3 2 11/22/2004

PLEITEZ, NURIA F MD INC 1700181799 430 W BADILLO ST COVINA 91723-1829 626-859-2851 13 4 3 2 12/30/1994

EAST VALLEY COMMUNITY HEALTH APCC 1285046847 276 WEST COLLEGE STREET COVINA 91723-1902 626-919-4333 22 4 3 2 12/10/2015

DESAI, PRITI N MD 1932235587 315 N THIRD AVE STE 205 COVINA 91723-1905 (626) 332-4543 13 4 3 2 1/29/2010

KIDZ KARE DOC INC 1700063773 147 W COLLEGE STREET COVINA 91723-2008 (626) 332-2860 13 4 3 2 5/27/1993

AURORA MEDICAL CORPORATION 1053335406 11245 LOWER AZUSA RD EL MONTE 91731-1553 626-579-9541 12 4 3 2 2/8/2000

THE RECTOR WARDENS & VESTRY CHURCH OF OUR SAVIOUR

1245248376 4368 SANTA ANITA AVE EL MONTE 91731-1606 (626) 579-2190 25 4 3 2 4/7/2000

ASIAN PACIFIC HEALTH CARE VENTURE INC 1609147743 9960 BALDWIN PLACE EL MONTE 91731-2204 (626) 774-2988 22 4 3 2 12/20/2012

ALTAMED COMM HEALTH CLIN EL MONTE 1982814745 10418 VALLEY BLVD STE B EL MONTE 91731-2402 (626) 453-8466 22 4 3 2 10/27/1996

CHAVA, SREEDHAR MD INC 1700023942 3580 SANTA ANITA AVE SUITE A EL MONTE 91731-2455 (626) 444-2660 12 4 3 2 6/23/2009

ARDMORE MEDICAL GROUP INC 1578624672 3564 SANTA ANITA AVE STE. A EL MONTE 91731-2458 (626) 350-8101 12 4 3 2 6/24/1993

PEREZ, OMAR MD INC / PEREZ MEDICAL CLINIC

1043393465 10728 RAMONA BLVD STE A EL MONTE 91731-2601 (626) 442-9430 13 4 3 2 12/1/1992

EL MONTE CLINICA MEDICA GENERAL MEDICAL CENTER

1093762593 11026 VALLEY MALL EL MONTE 91731-2617 (626) 443-4300 12 4 3 2 9/17/1999

KPADUWA, JULIUS C MD AMC 1396893723 11017 VALLEY MALL EL MONTE 91731-2617 (626) 575-8342 12 4 3 2 10/23/2002

CHEN, CRISPINA A MD INC 1558464107 10802 RAMONA BLVD EL MONTE 91731-2628 (626) 443-8918 13 4 3 2 8/17/1989

CO OF L.A. - EL MONTE COMPREHENSIVE HC 1972516631 10953 RAMONA BLVD EL MONTE 91731-2698 (626) 434-2500 22 4 3 2 3/10/2004

KOH, SANDY S MD INC 1083726905 3419 TYLER AVE EL MONTE 91731-3103 (626) 350-2197 13 4 3 2 7/30/2007

ADHAMI, AFSHIN S MD 1104991686 3030 TYLER AVE EL MONTE 91731-3352 (626) 350-9540 13 4 3 2 8/15/2000

COMMUNITY HEALTH ALLIANCE OF PASADENA 1477924520 3703 PECK ROAD EL MONTE 91731-3543 626-788-0280 22 4 3 2 12/27/2016

SWANSON, WILLIAM C MD 1568521938 4200 PECK RD STE B EL MONTE 91732-2177 (626) 350-5073 13 4 3 2 11/15/2004

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

CO OF L.A. - LAC+USC EAST SAN GABRIEL VALLEY

1316187255 4024 N DURFEE AVE EL MONTE 91732-2510 (626) 450-8936 22 4 3 2 5/11/2011

SOUTHERN CALIFORNIA MED CTR 1225357114 12100 VALLEY BLVD STE 109A EL MONTE 91732-3100 (626) 575-7500 22 4 3 2 6/7/1995

MAYFLOWER MEDICAL GROUP INC 1003188160B 11436 GARVEY AVE STE A, B EL MONTE 91732-3304 (626) 459-5420 12 4 3 2 9/17/2019

CROWN CITY MEDICAL GROUP 1619090610 3208 SANTA ANITA AVE STE 200 EL MONTE 91733-1360 (626) 454-1990 12 4 3 2 3/15/1994

RANGARAJAN, ALAGIA S, MD RANGA MEDICAL CLINIC

1841382025 3131 SANTA ANITA AVE STE 102 EL MONTE 91733-1369 (626) 448-6222 13 4 3 2 9/3/1985

CENTRAL CITY COMMUNITY HEALTH CENTER INC

1972912236 10050 GARVEY AVE STE 111 EL MONTE 91733-2088 626-652-0790 22 4 3 2 6/12/2017

COMPREHENSIVE MEDICAL CENTER, INC 1063551257 10301 GARVEY AVE STE 100 EL MONTE 91733-2180 (626) 448-0468 12 4 3 2 3/9/2005

KOH, SANDY S MD INC 1134364748 2727 N PECK RD EL MONTE 91733-2434 (626) 350-2196 13 4 3 2 11/22/1982

COMMUNITY HEALTH ALLIANCE OF PASADENA 1578808200 10408 VACCO ST STE A SOUTH EL MONTE 91733-3328 626-486-9640 22 4 3 2 10/21/2013

DURFEE FAMILY CARE MEDICAL GROUP, APC 1972828085 2006 DURFEE AVE EL MONTE 91733-3713 (626) 442-5015 13 4 3 2 11/27/1996

NGUYEN, TAN VAN MD INC 1437180395 9646 E GARVEY AVE STE 101 SOUTH EL MONTE 91733-4600 (626) 450-0777 13 4 3 2 8/22/1996

KPADUWA, JULIUS C MD AMC 1780733048 15913 AMAR RD LA PUENTE 91744 (626) 330-9535 12 4 3 2 11/10/1999

CLINICA MEDICA DEL SOL GROUP INC 1174833974 1431 NO HACIENDA BLVD LA PUENTE 91744-1133 626-918-3828 12 4 3 2 9/22/2014

CHAVA, SREEDHAR MD INC 1104163781 1651 N HACIENDA BLVD LA PUENTE 91744-1137 (626) 917-8700 12 4 3 2 2/25/2014

SHAMS A. MOUSAVILAR, MD, INC. 1003301573 1840 N HACIENDA BLVD STE 4 LA PUENTE 91744-1143 (626) 727-2150 13 4 3 2 12/17/2018

LOS NINOS CHILDRENS MEDICAL CLINIC APC 1700115722B 1240 N HACIENDA BLVD., STE 101 LA PUENTE 91744-1663 (626) 850-5005 13 4 3 2 1/25/2002

EAST VALLEY COMMUNITY HEALTH CENTER INC

1386912202 17840 VILLA CORTA STREET LA PUENTE 91744-5342 (626) 919-4333 22 4 3 2 7/5/2012

CO OF L.A. - LA PUENTE SUBCENTER 1770596439 15930 CENTRAL AVE LA PUENTE 91744-5410 (626) 968-3711 22 4 3 2 7/25/2005

JWCH INSTITUTE, INC 1104274596 15898 W GALE AVE HACIENDA HEIGHTS

91745-1432 (626) 346-3750 25 4 3 2 8/15/2017

PANG, ARNOLD T DO INC 1962666156 15572 E GALE AVE HACIENDA HEIGHTS

91745-1513 (626) 377-4562 13 4 3 2 8/26/2010

HEALTH ALLIANCE MED GRP 1124248570 17170 COLIMA RD STE G HACIENDA HTS 91745-6771 (626) 810-0706 12 4 3 2 5/27/1993

HUANG, HELEN MD DBA VINEYARD PEDIATRICS

1053322743 1850 S AZUSA AVE STE 209 HACIENDA HEIGHTS

91745-6854 (626) 810-8688 13 4 3 2 2/13/1996

CENTRAL CITY COMMUNITY HEALTH CENTER INC

1528477882 13742 AMAR ROAD LA PUENTE 91746-1683 626-919-0400 22 4 3 2 6/9/2017

YU CARE MEDICAL GRP INC 1235317561 1722 SOUTH DESIRE AVE SUITE 102

ROWLAND HEIGHTS

91748-0000 (626) 581-0700 12 4 3 2 9/3/2008

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

KIM, MILAN MD 1588761233 18895 COLIMA RD STE A ROWLAND HGHTS 91748-2978 (626) 581-2332 13 4 3 2 4/7/2000

WONG, TAN L MD 1790728749 2100 FOOTHILL BLVD SUITE A LA VERNE 91750-2905 (909) 596-1941 13 4 3 2 6/2/2005

PREMIER FAMILY MEDICINE ASSOCIATES, INC 1033634373 2333 FOOTHILL BLVD LA VERNE 91750-3027 (909) 392-6501 12 4 3 2 10/25/2018

LI, CONNIE J MD APC 1174064091 600 N GARFIELD AVE SUITE 311 MONTERREY PARK 91754-1171 (626) 573-8929 13 4 3 2 8/2/2018

LU JOSEPH T MD 1790795185 500 N GARFIELD AVE STE 202 MONTEREY PARK 91754-1242 (626) 572-8864 13 4 3 2 8/8/1996

KOO, ERLINDA L MD 1114936812 223 N GARFIELD AVE STE 201 MONTEREY PARK 91754-1700 (626) 573-4330 13 4 3 2 5/15/1980

CHEN, CHARLES C MD 1912922246 210 N GARFIELD AVE STE 306 MONTEREY PARK 91754-1746 (626) 571-6811 13 4 3 2 9/14/1983

GARFIELD HEALTH CENTER 1760480610 210 N GARFIELD SUITE 203 MONTEREY PARK 91754-1746 (626) 307-7397 22 4 3 2 10/31/2005

YU CARE MEDICAL GROUP INC 1639177587 210 N GARFIELD AVE SUITE 316 MONTEREY PARK 91754-1746 (626) 307-5500 12 4 3 2 6/17/1997

GARFIELD HEALTH CENTER 1548643000 701 S ATLANTIC BLVD STE 100 MONTEREY PARK 91754-3845 626-300-9980 22 4 3 2 12/8/2016

GARVEY HEALTHY FAMILY MEDICAL CLINIC INC

1740299833 705 E GARVEY AVE MONTEREY PARK 91755-3024 (626) 312-5488 13 4 3 2 2/1/2005

GARCIA, ANTONIO M MD 1821177833 586 E MISSION BLVD POMONA 91766-1938 (909) 622-6240 13 4 3 2 11/20/1997

WESTERN UNIVERSITY OF HEALTH SCIENCES 1679515217 795 E SECOND ST STE 5 POMONA 91766-2020 (909) 865-2565 12 4 3 2 12/2/2003

PEREZ, LUIS J MD APC 1225099880 716 E MISSION BLVD STE D POMONA 91766-2040 (909) 865-2332 13 4 3 2 8/31/2005

EAST VALLEY COMMUNITY HEALTH CENTER INC.

1649324443 1555 SOUTH GAREY AVE POMONA 91766-5222 (909) 620-8088 22 4 3 2 3/12/1998

FERAS AND HISHAM AMC INC 1700055274 2112 S GAREY AVE STE C POMONA 91766-5600 (909) 464-0520 12 4 3 2 8/30/1999

COMPREHENS MED CNTR INC CLINICA MED COMUNIDAD INC

1932249315 2286 S. GAREY AVE POMONA 91766-5645 (909) 464-2818 12 4 3 2 5/14/2007

POMONA COMMUNITY HEALTH CENTER 1417211426 1450 EAST HOLT AVE POMONA 91767 (909) 630-7927 22 4 3 2 8/5/2014

TOVAR, SONIA Y PROFESSIONAL CORPORATION NURSING

1679626428 1019 E. HOLT AVE POMONA 91767 (909) 623-7799 14 4 3 2 6/29/2015

LAUPPE, HOLLEMBERG, AGRAWAL KNOLL & WARREN

1366447781 250 W BONITA AVE STE 200 POMONA 91767-1850 (909) 629-5067 12 4 3 2 10/5/2010

CHAPARRAL MED GROUP INC 1528020112 790 E BONITA AVE FL 2 POMONA 91767-1906 (909) 447-8585 12 4 3 2 11/10/2010

EAST VALLEY COMMUNITY HEALTH CENTER INC

1649324443STA

2211 N ORANGE GROVE AVE ROOM 17

POMONA 91767-2319 (909) 620-8088 22 4 3 2 7/7/2017

AASTHA INC 1700171105 1920 N GAREY AVE POMONA 91767-2708 (909) 622-1235 13 4 3 2 10/20/2011

HUANG, CHING-CHIH D MD INC/SUNSHIE PEDIATRIC

1033139647 160 E ARTESIA ST STE 235 POMONA 91767-2900 (909) 397-5205 13 4 3 2 10/29/1990

GONZALEZ, JAIME MD INC. 1588730162 350 VINTON AVENUE SUITE 204 POMONA 91767-3000 (909) 622-3353 13 4 3 2 9/24/2007

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

PREMIER FAMILY MEDICINE ASSOCIATES INC 1912907114 1770 N ORANGE GROVE AVE STE 101

POMONA 91767-3027 (909) 469-9494 25 4 3 2 10/3/2002

JAMES J WU MEDICAL CORPORATION 1154857175 1818 N ORANGE GROVE AVE 200 POMONA 91767-3028 (909) 622-6433 13 4 3 2 11/27/2018

YU, KING YEE MD 1043300809 1902 ROYALTY DR STE 100 POMONA 91767-3053 (909) 620-4048 13 4 3 2 10/27/1999

HEALTHCARE MEDICAL CLINIC OF POMONA INC

1205961034 822 N. GAREY AVE POMONA 91767-4616 (909) 524-0555 12 4 3 2 5/5/2010

HA, TAM T MD 1205896206 756 E HOLT AVE POMONA 91767-5628 (909) 623-5369 13 4 3 2 8/17/1989

CHUNG GLORIA HA P DO 1134362205 1101 E HOLT AVENUE SUITE G POMONA 91767-5800 909-632-0895 13 4 3 2 5/14/2015

UNICARE COMMUNITY HEALTH CENTER INC 1356763155 1501 E HOLT AVENUE STE A POMONA 91767-5823 909-623-3600 22 4 3 2 6/13/2016

DADABHOY, SHAHIDA A PROFESSIONAL CORPORATION

1639585482 145 W WILLOW STREET POMONA 91768-1829 909-865-5555 13 4 7 2 1/3/2007

KAGWA-NYANZI, J PEDIATRICS CLINIC 1073741039 117 W WILLOW STREET SUITE B POMONA 91768-1829 (909) 865-5519 13 4 3 2 1/17/2002

GOODFAITH FAMILY MEDICAL CLINIC 1952323800 7770 GARVEY AVE ROSEMEAD 91770 (626) 307-4785 12 4 3 2 5/19/2001

CHILDREN AND ADULT MEDICAL GROUP INC. 1841337532 9246 VALLEY BLVD STE A ROSEMEAD 91770-1922 (626) 571-6908 13 4 3 2 6/12/2006

LII, SHYH-MINE MD 1922150267 3859 N ROSEMEAD BLVD ROSEMEAD 91770-1976 (626) 572-4044 13 4 3 2 8/13/1998

TRINH, MYLINH MD INC 1285043703 9143 VALLEY BLVD SUITE 201A ROSEMEAD 91770-1992 626-872-0657 13 4 3 2 5/2/2016

FAN, BUNCHEN R MD 1588665657 4124 ROSEMEAD BLVD STE A ROSEMEAD 91770-4400 (626) 285-2477 13 4 3 2 2/17/1998

SHIH, JENNIFER L MD 1750447264 4124 ROSEMEAD BLVD STE A ROSEMEAD 91770-4400 (626) 285-2477 13 4 3 2 10/25/1995

TRUONG, CAROLINE N MD 1679579809 9014 GARVEY AVE STE I ROSEMEAD 91770-5306 (626) 572-3955 13 4 3 2 9/22/2005

MODI, KANAN A MD INC 1881704898 1305 W ARROW HWY STE 104 SAN DIMAS 91773-2337 (909) 394-9004 13 4 3 2 4/27/2009

NGO, HY PHUNG MD INC 1144385766 625 E VALLEY BLVD STE H & I SAN GABRIEL 91776 626-572-4658 13 4 3 2 9/27/2013

VARMA, USHA K MD 1457362527 416 W LAS TUNAS DR STE 201 SAN GABRIEL 91776 (626) 285-9705 13 4 3 2 1/6/1998

KONG-THEIN, LORNA MD APC 1396828554 207 S SANTA ANITA AVE STE 330 SAN GABRIEL 91776-1154 (626) 458-1888 13 4 3 2 8/15/2003

HERALD CHRISTIAN HEALTH CENTER 1033390273 923 S SAN GABRIEL BLVD SAN GABRIEL 91776-2743 (626) 286-8700 22 4 3 2 8/5/2009

PORRAL, AZUCENA A MD 1881793743 5546 ROSEMEAD BLVD STE 102 TEMPLE CITY 91780-1855 (626) 285-9600 13 4 3 2 9/15/2009

WU PEDIATRICS CORP 1831565670 5817 TEMPLE CITY BLVD TEMPLE CITY 91780-2113 626-285-1254 12 4 3 2 6/12/2018

MAYFLOWER MEDICAL GROUP INC 1003188160A 140 N ORANGE AVE STE 104 WEST COVINA 91790-2032 (626) 800-1200 12 4 2 8/2/2016

LAKESIDE MEDICAL 1831426642A 1500 W WEST COVINA PKWY WEST COVINA 91790-2703 (626) 960-9414 12 4 3 2 4/10/2008

EAST VALLEY COMM HLTH 1831243625 420 S GLENDORA AVE WEST COVINA 91790-3001 (626) 919-4333 22 4 3 2 11/4/1997

ACTIVE HEALTHCARE MEDICAL GROUP INC 1699955575 512 S GLENDORA AVE WEST COVINA 91790-3022 (626) 337-2888 13 4 3 2 9/22/2003

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

ALTAMED HEALTH SERVICES CORPORATION 1730481318 1300 S SUNSET AVE WEST COVINA 91790-3342 (626) 960-6999 22 4 3 2 6/25/2012

JUST 4 KIDS PEDIATRICS, INC 1457608580 1433 W MERCED AVE STE 103 WEST COVINA 91790-3402 (626) 502-1214 13 4 3 2 12/26/2012

KIM, KUM SON MD 1306905112 1433 W MERCED AVE STE 217 WEST COVINA 91790-3402 (626) 917-1924 13 4 3 2 1/3/1984

CITRUS VALLEY PHYSICIAN PARTNERS 1881054997 1535 W MERCED AVE STE 300 WEST COVINA 91790-3404 626-962-8122 12 4 3 2 8/30/2016

KUMAR, ASHA R MD INC 1447437165 820 W SERVICE AVE WEST COVINA 91790-3716 (626) 960-6304 13 4 3 2 1/17/1997

LOS NINOS CHILDREN MEDICAL CLINIC APC 1700115722A 409 E MERCED AVE WEST COVINA 91790-5061 (626) 931-0901 13 4 3 2 7/28/2005

CHAN, EVA YEE-FUN, MD 1508953894 2707 E VALLEY BLVD STE 215 WEST COVINA 91792 (909) 594-3382 13 4 3 2 1/25/1993

CHINATOWN SERVICE CENTER 1134482326 320 S GARFIELD AVE SUITE 118 ALHAMBRA 91801-3886 (626) 773-3388 22 4 4 2 12/2/2015

AMG, A PROF MEDICAL CORP 1558306266 925 S GARFIELD AVE ALHAMBRA 91801-4442 (626) 282-0282 12 4 3 2 12/23/1996

NGUYEN, SAN T MD INC 1194738849 1021 S GARFIELD AVE ALHAMBRA 91801-4710 (626) 282-6311 13 4 3 2 9/7/1988

STEWART AND STEWART MDS INC 1306058565 1024 S GARFIELD AVE ALHAMBRA 91801-4762 (626) 289-5181 12 4 3 2 8/5/1986

KONG, ARTHUR MD 1790835338 1048 S GARFIELD AVE STE 100 ALHAMBRA 91801-4768 (626) 282-7585 13 4 3 2 10/25/1977

LAU, MAY Y MD INC 1992805550 320 S GARFIELD AVE STE 288 ALHAMBRA 91801-6815 (626) 607-0288 13 4 3 2 7/11/2006

NGUYEN, TANYA T MD INC 1184729626 320 S GARFIELD AVE STE 288 ALHAMBRA 91801-6815 (626) 607-0288 13 4 3 2 7/7/2006

ALHAMBRA FAMILY MEDICAL CENTER INC AMPC

1851324206 1336 W VALLEY BLVD, SUITE A ALHAMBRA 91803-2480 (626) 281-2232 12 4 3 2 1/5/2006

TARZANA TREATMENT CENTER FMLY MED CLNC-LANCASTER

1881710861 907 W LANCASTER BLVD LANCASTER 93534-2350 (661) 723-4829 25 4 1 1 8/20/2001

SATEY, FARIBORZ D MD INC 1356489629A 1707 W AVENUE J LANCASTER 93534-2703 661-949-5929 12 4 1 1 10/3/2012

GAW, BRIAN K MD INC 1932409257 1669 WEST AVENUE J STE 304 LANCASTER 93534-2870 (661) 951-7888 12 4 1 1 8/2/2011

CO OF L.A. - HIGH DESERT HEALTH SYSTEMS 1003929829A 335 EAST AVENUE I LANCASTER 93535-1916 (661) 471-4055 22 4 1 1 10/5/2005

CO OF L.A.- HIGH DESERT RGNL HLTH CTR, SCAN/HUB

1003929829B 335 EAST AVENUE I LANCASTER 93535-1916 661-471-4055 21 4 1 1 12/12/2006

BARTZ ALTADONNA COMMUNITY HEALTH CENTER

1811279763 43322 GINGHAM AVE STE 104 AND 105

LANCASTER 93535-4569 (661) 874-4050 22 4 2 1 12/31/2012

CO OF L.A. - ANTELOPE VALLEY HLTH CTR 1336152578 335 E AVENUE K6 STE B LANCASTER 93535-4645 (661) 471-4400 22 4 1 1 3/24/2003

CO OF L.A. - LITTLEROCK COMMUNITY CLN 1467565283 8201 PEARBLOSSOM HWY LITTLEROCK 93543-3042 661-225-3155 22 4 1 1 10/29/2009

KHAMIS, SHERIF MD INC 1225302789B 2271 E PALMDALE BLVD SUITE E PALMDALE 93550-1340 661-538-9922 13 4 1 1 12/23/2014

ROY MEDICAL GROUP INC 1801921952C 1543 E PALMDALE BLVD STE C PALMDALE 93550-2030 (661) 274-1200 12 4 1 1 10/20/2008

ROY MEDICAL GROUP INC 1801921952D 1543 E PALMDALE BLVD STE F PALMDALE 93550-2030 661-274-1200 12 4 1 1 1/22/2015

TEPERSON, ANDREW L, MD 1598705170 1224 E. AVENUE S , STE A PALMDALE 93550-6180 (661) 274-8666 13 4 1 1 6/8/2005

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Site Name NPI# Site Address City Zip Telephone Type Category SPA Region Date Activated

CO OF L.A. - LAKE LA COMMUNITY CLINIC 1821101643 16921 E AVENUE O SPC G PALMDALE 93551-3045 (661) 945-8488 22 4 1 1 1/23/2004

SATEY, FARIBORZ D MD INC 1356489629B 627 W AVENUE Q STE D PALMDALE 93551-3891 (661) 272-5656 12 4 1 1 4/19/2002

CO OF L.A. - SOUTH VALLEY HEALTH CTR 1649383464 38350 40TH ST E STE 100 PALMDALE 93552-3075 661-225-3000 22 4 1 1 11/20/2002

CO OF L.A. - SOUTH VALLEY PED SATELLITE CLINIC

1649383464STA

38350 40TH STREET EAST SUITE 200

PALMDALE 93552-3075 (661) 272-5001 22 4 1 1 11/8/2012

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