Organization
EAST VALLEY COMMUNITY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA MARDINI (CHIEF EXECUTIVE OFFICER)
(626) 919-4333
Entity
Organization
Contact information
Practice address
2211 N ORANGE GROVE AVE, POMONA, CA 91767-2319
(626) 919-4333
Mailing address
420 S GLENDORA AVE, WEST COVINA, CA 91790-3001
(626) 919-4333
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
960000806
STATE OF CALIFORNIA DEPARTMENT OF PUBLIC HEALTH
CA
Enumeration date
08/16/2022
Last updated
08/16/2022
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