Organization
EAST VALLEY COMMUNITY HEALTH CENTER, INC.
Active
Organization
EAST VALLEY COMMUNITY HEALTH CENTER, INC.
Active
Other names
East Valley Community Health Center, Inc.-Intercommunity Campus
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA MARDINI (CHIEF EXEC. OFFICER)
(626) 919-4333
Entity
Organization
Contact information
Practice address
276 WEST COLLEGE STREET, COVINA, CA 91723-1902
(626) 919-4333
(626) 919-2084
Mailing address
420 SOUTH GLENDORA AVENUE, WEST COVINA, CA 91790-3001
(626) 919-4333
(626) 919-2084
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
960000806
CA
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC12048F
—
CA
Enumeration date
05/29/2014
Last updated
02/11/2022
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