CANOGA PARK HEALTH CENTER - NPI 1740281120 - Clinic/Center in Canoga Park, CA

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).

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About Canoga Park Health Center NPPES

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

CANOGA PARK HEALTH CENTER (NPI 1740281120) is a healthcare organization registered as a federally qualified health center (fqhc) in Canoga Park, California and active in the NPI registry since August 2005. The organization lists Kimberly Wyard, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1740281120

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameNORTHEAST VALLEY HEALTH CORPORATION

Location Address7107 REMMET AVECanoga Park, CA 91303-2016

Mailing Address1172 N Maclay AveSan Fernando, CA 91340-1328 · (818) 898-1388 · Fax (818) 365-4031

Phone(818) 340-3570

Fax(818) 702-9578

Organization SubpartNo

Authorized OfficialKimberly WyardChief Executive Officer · (818) 898-1388

Enumeration DateAugust 9, 2005

Last NPPES UpdateMarch 3, 20222 updates tracked since enumeration

NPPES CertifiedMarch 3, 2022

✔ NPI 1740281120 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

Also ListedClinic/Center · Community HealthTaxonomy 261QC1500X · License 9600963 (CA)

7107 REMMET AVE, Canoga Park, CA 91303

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Other Names 1

Doing Business AsCanoga Park Health Center

Other Identifiers 1

OtherW14819BMin

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

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. BUENAFLOR RAMOS UY M.D.

Pediatrics