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HARBOR COMMUNITY CLINIC
NPI 1467490425
Clinic/Center - Federally Qualified Health Center (FQHC) in San Pedro, CA

Active since June 03, 2006
593 W 6TH ST, SAN PEDRO, CA 90731(310) 547-0202(310) 547-5096 Get Directions Write a Review

NPPES record last updated: February 8, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 8, 2022, Jan 25, 2016 (2 updates tracked since 2016).

About Harbor Community Clinic NPPES

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

HARBOR COMMUNITY CLINIC (NPI 1467490425) is a healthcare organization registered as a federally qualified health center (fqhc) in San Pedro, California and active in the NPI registry since June 2006. The organization lists Tamra King, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1467490425
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameHARBOR COMMUNITY CLINIC INC.
Location Address593 W 6TH STSan Pedro, CA 90731-2521
Mailing Address593 W 6th StSan Pedro, CA 90731-2521 · (310) 547-0202 · Fax (310) 547-5096
Phone(310) 547-0202
Fax(310) 547-5096
Organization SubpartNo
Authorized OfficialTamra KingExecutive Director · (310) 547-8241
Enumeration DateJune 3, 2006
Last NPPES UpdateFebruary 8, 20222 updates tracked since enumeration
NPPES CertifiedFebruary 7, 2022
✔ NPI 1467490425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
License✔ Licensed in CA · 960000085
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
593 W 6TH ST, San Pedro, CA 90731
Open in Google Maps ↗

Other Names 1

Doing Business AsHarbor Community Clinic

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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)

Harbor Community Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

17

Medicare enrollment records show 17 clinicians reassign Medicare billing to Harbor Community Clinic, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 9 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 7

Family Practice6
Clinical Social Worker3
Nurse Practitioner3
Pediatric Medicine2
Clinical Psychologist1
Podiatry1
Psychiatry1

Clinicians, nearest first (17)

Oluwafemisayo Akinnagbe, MD
Family Practice
NPI 1316567043
593 W 6TH ST
San Pedro, CA 90731
(310) 547-0202
✔ PECOS✔ Accepts MedicareSame address
Evelyn Desser, RN, MN, FNP-BC
Nurse Practitioner
NPI 1255459129
593 W 6TH ST
San Pedro, CA 90731
(310) 547-0202
✔ PECOS✔ Accepts MedicareSame address
Caleb Lusk, MD
Family Practice
NPI 1386149912
593 W 6TH ST
San Pedro, CA 90731
(310) 547-0202
✔ PECOS✔ Accepts MedicareSame address
Mayra Perez Gonzalez
Clinical Social Worker
NPI 1215286950
593 W 6TH ST
San Pedro, CA 90731
(310) 547-0202
✔ PECOS✔ Accepts MedicareSame address
Dianne Bohorquez, PH.D.
Clinical Psychologist
NPI 1467617142
593 W 6TH ST
San Pedro, CA 90731
(310) 547-0202
✔ PECOS✔ Accepts MedicareSame address
Jeffrey Ramirez, MD
Pediatric Medicine
NPI 1568090132
425 S PACIFIC AVE
San Pedro, CA 90731
(310) 547-0202
✔ PECOS0.1 mi
Hind Bennani, DPM
Podiatry
NPI 1073702213
6051 FLAMBEAU RD
Rancho Palos Verdes, CA 90275
(305) 793-6278
✔ PECOS✔ Accepts Medicare6.3 mi
Joseph Gancayco
Pediatric Medicine
NPI 1366070815
1000 W CARSON ST
Torrance, CA 90502
(310) 222-2321
✔ PECOS6.4 mi
Shribala Kumar, MD
Psychiatry
NPI 1003934423
1975 LONG BEACH BLVD
Long Beach, CA 90806
(562) 218-4017
✔ PECOS✔ Accepts Medicare6.9 mi
Michael Montecillo, LCSW
Clinical Social Worker
NPI 1174779425
1045 W REDONDO BEACH BLVD
Gardena, CA 90247
(233) 241-6730
✔ PECOS11 mi
Jin Gyo Jung
Nurse Practitioner
NPI 1669226478
9840 JERSEY AVE UNIT 8
Santa Fe Springs, CA 90670
(714) 913-3086
✔ PECOS✔ Accepts Medicare19 mi
Anthony Jackson, MSW, LCSW
Clinical Social Worker
NPI 1669722708
2390 E ORANGEWOOD AVE STE 300
Anaheim, CA 92806
(714) 543-4333
✔ PECOS✔ Accepts Medicare24 mi
Yen Nguyen, FNP-BC
Nurse Practitioner
NPI 1255047957
1625 SCHRADER BLVD
Los Angeles, CA 90028
(323) 993-7500
✔ PECOS✔ Accepts Medicare25 mi
Suneun Reichert, DO
Family Practice
NPI 1083031769
1 HOPE DR
Tustin, CA 92782
(714) 247-0300
✔ PECOS26 mi
Warren Yamashita, MD, MPH
Family Practice
NPI 1982137691
1 HOPE DR
Tustin, CA 92782
(714) 247-0300
✔ PECOS✔ Accepts Medicare26 mi
Veronica Aguilar, MD
Family Practice
NPI 1588169007
14642 NEWPORT AVE STE 200
Tustin, CA 92780
(714) 247-0300
✔ PECOS✔ Accepts Medicare27 mi
Kevin Metzger, DO
Family Practice
NPI 1689847725
10841 WHITE OAK AVE
Rancho Cucamonga, CA 91730
(310) 994-2822
✔ PECOS✔ Accepts Medicare49 mi

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

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 Harbor Community Clinic Inc.'s NPI number?

The NPI number for Harbor Community Clinic Inc. is 1467490425. It was assigned to this organization in the NPPES registry on June 3, 2006. The provider is doing business as Harbor Community Clinic.

Where is Harbor Community Clinic Inc. located?

Harbor Community Clinic Inc. is located at 593 W 6th St, San Pedro, CA 90731. The listed phone number is (310) 547-0202.

What is Harbor Community Clinic Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Is Harbor Community Clinic Inc. enrolled in Medicare?

Yes. Harbor Community Clinic Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Harbor Community Clinic Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 17 clinicians in 7 Medicare specialties reassign their Medicare billing to Harbor Community Clinic 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. The largest specialties are Family Practice (6), Clinical Social Worker (3) and Nurse Practitioner (3). Of these, 5 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Harbor Community Clinic Inc. was last updated on February 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.