| Organization Name: | CENTRAL CITY COMMUNITY HEALTH CENTER |
| NPI Number: | 1174757967 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GILBERT VARELA (CEO) |
| Mailing Address: | 12116 Beach Blvd Stanton |
| State: | CA US |
| Postal Code: | 906803704 |
| Phone Number: | 7148952764 |
| Fax Number: | |
| NPI Enumeration Date: | 05/07/2009 |
| NPI Last Update Date: | 05/07/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | 960000901 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |