3C COMMUNITY CLINIC
NPI 1093167850
Clinic/Center - Federally Qualified Health Center (FQHC) in Los Angeles, CA

NPI Status: Active since July 05, 2016

Contact Information

3030 W OLYMPIC BLVD STE 206
LOS ANGELES, CA
ZIP 90006
Phone: (310) 658-4494

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  • Organization
  • Clinic/Center
  • Federally Qualified Health Center (FQHC)
  • CLIA Number: 05D2121401
  • CLIA Cert. Type: Blood Bank
  • CLIA Exp. Date: 11-02-2026

About 3C COMMUNITY CLINIC

This page provides the complete NPI Profile along with additional information for 3c Community Clinic, a primary care provider established in Los Angeles, California operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1093167850 assigned on July 2016. The practitioner's primary taxonomy code is 261QF0400X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The authorized official of this NPI record is Jaesung Kim (Ceo)

NPI
1093167850
Provider Name
3C COMMUNITY CLINIC
Entity Type
Organization
Location Address
3030 W OLYMPIC BLVD STE 206 LOS ANGELES, CA 90006
Location Phone
(310) 658-4494
Mailing Address
3030 W OLYMPIC BLVD STE 206 LOS ANGELES, CA 90006
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-05-2016
Last Update Date
05-12-2023
Code Navigator

A primary care provider (PCP) like 3c Community Clinic sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Federally Qualified Health Center (FQHC)

Taxonomy Code
261QF0400X
Type
Ambulatory Health Care Facilities

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1261QC1500XAmbulatory Health Care Facilities

Clinic/Center
Community Health

 

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JAESUNG KIM

Authorized Official Title
CEO
Authorized Official Phone
(213) 322-2666

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D2121401
Facility Type
Blood Bank
Certificate Effective Date
November 03, 2024
Certificate Expiration Date
November 02, 2026
Laboratory Director
JAE HYUNG CHO
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to 3c Community Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for 3C COMMUNITY CLINIC

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1093167850, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
3
Unchanged
Pos 5
1
Doubled → 2
Pos 6
6
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
8
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 1 → 2 7 → 14 → 5 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 8 + 3 + 2 + 6 + 1 + 4 + 8 + 1 + 0 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1093167850.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
3030 W OLYMPIC BLVD STE 206
LOS ANGELES, CA 90006
Nurse Practitioner (Pediatrics)
3030 W OLYMPIC BLVD STE 206
LOS ANGELES, CA 90006

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1093167850, enumerated as an "organization" on July 05, 2016.

The provider is located at 3030 W OLYMPIC BLVD STE 206 LOS ANGELES, CA 90006 and the phone number is (310) 658-4494.

Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).