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HARBOR COMMUNITY CLINIC INC
NPI 1831739614
Pediatrics in San Pedro, CA

Active since January 09, 2020
425 S PACIFIC AVE, SAN PEDRO, CA 90731(310) 547-0202(310) 547-0202 Get Directions Write a Review

NPPES record last updated: January 9, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Harbor Community Clinic Inc NPPES

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

HARBOR COMMUNITY CLINIC INC (NPI 1831739614) is a healthcare organization registered as a pediatrics in San Pedro, California and active in the NPI registry since January 2020. The organization lists Tamra King, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1831739614
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameHARBOR COMMUNITY CLINIC INC
Location Address425 S PACIFIC AVESan Pedro, CA 90731-2625
Mailing Address593 W 6th StSan Pedro, CA 90731-2521 · (310) 547-0202 · Fax (310) 547-5096
Phone(310) 547-0202
Fax(310) 547-0202
Organization SubpartNo
Authorized OfficialTamra KingChief Executive Officer · (310) 547-8241
Enumeration DateJanuary 9, 2020
✔ NPI 1831739614 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
425 S PACIFIC AVE, San Pedro, CA 90731
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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 Inc 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 Inc, which bills Medicare for the services they deliver. Of these, 1 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)

Jeffrey Ramirez, MD
Pediatric Medicine
NPI 1568090132
425 S PACIFIC AVE
San Pedro, CA 90731
(310) 547-0202
✔ PECOSSame address
Oluwafemisayo Akinnagbe, MD
Family Practice
NPI 1316567043
593 W 6TH ST
San Pedro, CA 90731
(310) 547-0202
✔ PECOS✔ Accepts Medicare0.1 mi
Evelyn Desser, RN, MN, FNP-BC
Nurse Practitioner
NPI 1255459129
593 W 6TH ST
San Pedro, CA 90731
(310) 547-0202
✔ PECOS✔ Accepts Medicare0.1 mi
Caleb Lusk, MD
Family Practice
NPI 1386149912
593 W 6TH ST
San Pedro, CA 90731
(310) 547-0202
✔ PECOS✔ Accepts Medicare0.1 mi
Mayra Perez Gonzalez
Clinical Social Worker
NPI 1215286950
593 W 6TH ST
San Pedro, CA 90731
(310) 547-0202
✔ PECOS✔ Accepts Medicare0.1 mi
Dianne Bohorquez, PH.D.
Clinical Psychologist
NPI 1467617142
593 W 6TH ST
San Pedro, CA 90731
(310) 547-0202
✔ PECOS✔ Accepts Medicare0.1 mi
Joseph Gancayco
Pediatric Medicine
NPI 1366070815
1000 W CARSON ST
Torrance, CA 90502
(310) 222-2321
✔ PECOS6.3 mi
Hind Bennani, DPM
Podiatry
NPI 1073702213
6051 FLAMBEAU RD
Rancho Palos Verdes, CA 90275
(305) 793-6278
✔ PECOS✔ Accepts Medicare6.3 mi
Shribala Kumar, MD
Psychiatry
NPI 1003934423
1975 LONG BEACH BLVD
Long Beach, CA 90806
(562) 218-4017
✔ PECOS✔ Accepts Medicare6.7 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 Medicare26 mi
Kevin Metzger, DO
Family Practice
NPI 1689847725
10841 WHITE OAK AVE
Rancho Cucamonga, CA 91730
(310) 994-2822
✔ PECOS✔ Accepts Medicare48 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 1831739614. It was assigned to this organization in the NPPES registry on January 9, 2020.

Where is Harbor Community Clinic Inc located?

Harbor Community Clinic Inc is located at 425 S Pacific Ave, 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 Pediatrics with taxonomy code 208000000X.

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, 1 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 January 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.