HARBOR COMMUNITY CLINIC INC
NPI 1831739614
Pediatrics in San Pedro, CA
- Organization
- Pediatrics
- CLIA Number: 05D0698919
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 09-13-2027
About HARBOR COMMUNITY CLINIC INC
This page provides the complete NPI Profile along with additional information for Harbor Community Clinic Inc, a pediatrician established in San Pedro, California operating as a Pediatrics. The healthcare provider is registered in the NPI registry with number 1831739614 assigned on January 2020. The practitioner's primary taxonomy code is 208000000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. Harbor Community Clinic Inc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Tamra King (Chief Executive Officer)
- NPI
- 1831739614 Verify this NPI
- Provider Name
- HARBOR COMMUNITY CLINIC INC
- Entity Type
- Organization
- Location Address
- 425 S PACIFIC AVE SAN PEDRO, CA 90731
- Location Phone
- (310) 547-0202
- Location Fax
- (310) 547-0202
- Mailing Address
- 593 W 6TH ST SAN PEDRO, CA 90731
- Mailing Phone
- (310) 547-0202
- Mailing Fax
- (310) 547-5096
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-09-2020
- Last Update Date
- 01-09-2020
- Code Navigator
A pediatrician like Harbor Community Clinic Inc is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D0698919
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- September 14, 2025
- Certificate Expiration Date
- September 13, 2027
- Laboratory Director
- CALEB LUSK
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Harbor Community Clinic Inc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1831739614, enumerated as an "organization" on January 09, 2020.
The provider is located at 425 S PACIFIC AVE SAN PEDRO, CA 90731 and the phone number is (310) 547-0202.
Pediatrics with taxonomy code 208000000X.
