GRACELIGHT COMMUNITY HEALTH
NPI 1104075282
Clinic/Center - Federally Qualified Health Center (FQHC) in Los Angeles, CA
NPI Status: Active since September 15, 2008
Contact Information
4816 E 3RD ST
LOS ANGELES, CA
ZIP 90022
Phone: (323) 780-4510
Fax: (323) 780-6132
- Organization
- Clinic/Center
- Federally Qualified Health Center (FQHC)
- CLIA Number: 05D1097714
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 03-31-2027
About GRACELIGHT COMMUNITY HEALTH
This page provides the complete NPI Profile along with additional information for Gracelight Community Health, 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 1104075282 assigned on September 2008. The practitioner's primary taxonomy code is 261QF0400X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's
- NPI
- 1104075282
- Provider Legal Name
- GRACELIGHT COMMUNITY HEALTH
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 4816 E 3RD ST LOS ANGELES, CA 90022
- Location Phone
- (323) 780-4510
- Location Fax
- (323) 780-6132
- Mailing Address
- 4816 E 3RD ST LOS ANGELES, CA 90022
- Mailing Phone
- (323) 780-4510
- Mailing Fax
- (323) 780-6132
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-15-2008
- Last Update Date
- 10-29-2025
- Code Navigator
A primary care provider (PCP) like Gracelight Community Health 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
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| W6997D | OTHER (01) | CA | MEDICARE PROVIDER NUMBER |
| CMM70660F | MEDICAID (05) | CA | |
| 55-1019 | OTHER (01) | CA | MEDICARE FQHC PROVIDER NUMBER |
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
- 05D1097714
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- April 01, 2025
- Certificate Expiration Date
- March 31, 2027
- Laboratory Director
- DEANAH A. JIBRIL
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Gracelight Community Health 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.
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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 1104075282, we treat the final digit (2) 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 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 2).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 48 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104075282, enumerated as an "organization" on September 15, 2008.
The provider is located at 4816 E 3RD ST LOS ANGELES, CA 90022 and the phone number is (323) 780-4510.
Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
