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SAN RAFAEL COMMUNITY MEDICAL CLINIC
NPI 1881811404
Family Medicine in Azusa, CA

Active since April 18, 2007CLIA 05D0988761 · Waiver
647 E ARROW HWY, AZUSA, CA 91702(626) 858-5199(626) 858-5299 Get Directions Write a Review

NPPES record last updated: June 16, 2016. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About San Rafael Community Medical Clinic NPPES

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

SAN RAFAEL COMMUNITY MEDICAL CLINIC (NPI 1881811404) is a healthcare organization registered as a family medicine in Azusa, California and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through July 8, 2027 and lists Rafael Carcamo, President, as its authorized official.

NPPES Registry Identity

NPI1881811404
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFOOTHILL COMMUNITY MEDICAL CORP.
Location Address647 E ARROW HWYAzusa, CA 91702-5802
Mailing Address647 E Arrow HwyAzusa, CA 91702-5802 · (626) 858-5199 · Fax (626) 858-5299
Phone(626) 858-5199
Fax(626) 858-5299
Organization SubpartNo
Authorized OfficialRafael CarcamoPresident · (626) 858-5199
Enumeration DateApril 18, 2007
Last NPPES UpdateJune 16, 2016
✔ NPI 1881811404 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 · A66675
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.
647 E ARROW HWY, Azusa, CA 91702
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Other Names 1

Doing Business AsSan Rafael Community Medical Clinic

Other Identifiers 1

MedicaidGR0090650CA

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

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 05D0988761

Foothill Community Medical Corp/San Rafael Community Medical Clinic Inc · Azusa, CA
Active · expires Jul 8, 2027
CLIA Number05D0988761
Laboratory TypePhysician Office
Certificate Effective DateJuly 9, 2025
Certificate Expiration DateJuly 8, 2027
Laboratory DirectorRafael Carcamo MD
Laboratory Phone(626) 858-5199
Laboratory LocationFoothill Community Medical Corp/San Rafael Community Medical Clinic Inc647 E Arrow Hwy, Azusa, CA 91702
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

RAFAEL CARCAMO MD
Family Medicine
647 E ARROW HWY
AZUSA, CA 91702
Los Angeles County (626) 858-5199

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 Foothill Community Medical Corp.'s NPI number?

The NPI number for Foothill Community Medical Corp. is 1881811404. It was assigned to this organization in the NPPES registry on April 18, 2007. The provider is doing business as San Rafael Community Medical Clinic.

Where is Foothill Community Medical Corp. located?

Foothill Community Medical Corp. is located at 647 E Arrow Hwy, Azusa, CA 91702. The listed phone number is (626) 858-5199.

What is Foothill Community Medical Corp.'s specialty?

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

Does Foothill Community Medical Corp. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0988761) is associated with this NPI, valid through July 8, 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 Foothill Community Medical Corp. was last updated on June 16, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.