Provider Demographics
NPI:1497207229
Name:COMPLETE CARE COMMUNITY HEALTH CENTER, INC
Entity Type:Organization
Organization Name:COMPLETE CARE COMMUNITY HEALTH CENTER, INC
Other - Org Name:COMPLETE CARE COMMUNITY HEALTH CENTER - ALTADENA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:YURY
Authorized Official - Middle Name:
Authorized Official - Last Name:AKOPYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-266-6700
Mailing Address - Street 1:2595 E WASHINGTON BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-1409
Mailing Address - Country:US
Mailing Address - Phone:626-794-8133
Mailing Address - Fax:626-794-9163
Practice Address - Street 1:2595 E WASHINGTON BLVD STE 106
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-1409
Practice Address - Country:US
Practice Address - Phone:626-794-8133
Practice Address - Fax:626-794-9163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-27
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)