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GRACE FAMILY MEDICAL CLINIC
NPI 1215472048
Family Medicine in Cerritos, CA

Active since January 03, 2017CLIA 05D2135216 · Waiver
18331 GRIDLEY RD, SUITE A, CERRITOS, CA 90703(562) 865-3738 Get Directions Write a Review

NPPES record last updated: January 3, 2017. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Grace Family Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRACE FAMILY MEDICAL CLINIC (NPI 1215472048) is a healthcare organization registered as a family medicine in Cerritos, California and active in the NPI registry since January 2017. The organization holds a CLIA Waiver certificate valid through August 15, 2027 and lists John Ehum, President, as its authorized official.

NPPES Registry Identity

NPI1215472048
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameEJW INC
Location Address18331 GRIDLEY RD, SUITE ACerritos, CA 90703-5438
Mailing Address18331 Gridley Rd, Suite ACerritos, CA 90703-5438 · (562) 865-3738
Phone(562) 865-3738
Organization SubpartNo
Authorized OfficialJohn EhumPresident · (562) 865-3738
Enumeration DateJanuary 3, 2017
✔ NPI 1215472048 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A97838
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
18331 GRIDLEY RD, Cerritos, CA 90703
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Other Names 1

Doing Business AsGrace Family Medical Clinic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Grace Family Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Grace Family Medical Clinic, which bills Medicare for the services this clinician delivers.

Clinician (1)

John Ehum, MD
Family Practice
NPI 1942483409
800 N MAIN ST
Santa Ana, CA 92701
(714) 456-7002
✔ PECOS✔ Accepts Medicare15 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

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 of Waiver 05D2135216

Ejw Inc · Cerritos, CA
Active · expires Aug 15, 2027
CLIA Number05D2135216
Laboratory TypePhysician Office
Certificate Effective DateAugust 16, 2025
Certificate Expiration DateAugust 15, 2027
Laboratory DirectorJohn Ehum
Laboratory Phone(562) 865-3738
Laboratory LocationEjw Inc18331 Gridley Rd Ste A, Cerritos, CA 90703
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Ejw Inc's NPI number?

The NPI number for Ejw Inc is 1215472048. It was assigned to this organization in the NPPES registry on January 3, 2017. The provider is doing business as Grace Family Medical Clinic.

Where is Ejw Inc located?

Ejw Inc is located at 18331 Gridley Rd Suite A, Cerritos, CA 90703. The listed phone number is (562) 865-3738.

What is Ejw Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Ejw Inc enrolled in Medicare?

Yes. Ejw Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Ejw Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Ejw Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Ejw Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2135216) is associated with this NPI, valid through August 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ejw Inc was last updated on January 3, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.