VENICE SOUTH BAY GARDENA
NPI 1184297681
Clinic/Center - Federally Qualified Health Center (FQHC) in Gardena, CA
About Venice South Bay Gardena NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VENICE SOUTH BAY GARDENA (NPI 1184297681) is a healthcare organization registered as a federally qualified health center (fqhc) in Gardena, California and active in the NPI registry since July 2021. The organization holds 2 active CLIA laboratory certificates and lists Mitesh G Popat, Chief Executive Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Group Practice 1
CLIA Laboratory Certificates CMS CLIA 2
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0952854
Venice South Bay Gardena · Gardena, CACertificate for Provider-Performed Microscopy Procedures (PPMP) 05D0917672
Venice Family Clinic-Simms/Mann Health And Wellness Center · Santa Monica, CAOther Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Venice Family Clinic's NPI number?
The NPI number for Venice Family Clinic is 1184297681. It was assigned to this organization in the NPPES registry on July 21, 2021. The provider is also known as Venice South Bay Gardena.
Where is Venice Family Clinic located?
Venice Family Clinic is located at 742 W Gardena Blvd, Gardena, CA 90247. The listed phone number is (310) 802-6177.
What is Venice Family Clinic's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Does Venice Family Clinic hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
When was this NPI record last updated?
The NPPES record for Venice Family Clinic was last updated on November 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Venice South Bay Gardena · NPI 1184297681
Federally Qualified Health Center (FQHC) organization in Gardena, California. Organization record, active in the CMS NPPES registry since July 21, 2021.
## Identity
- **NPI:** 1184297681 (Entity type: Organization)
- **Enumerated:** July 21, 2021
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Venice Family Clinic
- **Organization subpart:** Yes (part of Venice Family Clinic)
- **Authorized official:** Mitesh Popat, CHIEF EXECUTIVE OFFICER
## Practice location
- **Address:** 742 W GARDENA BLVD, Gardena, CA 90247-5024
- **Phone:** (310) 802-6177 · **Fax:** (310) 802-6178
## Record status
- **NPPES last updated:** November 30, 2023
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1184297681) · Data from the CMS NPPES public registry.