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TRI-STATE COMMUNITY HEALTHCARE CENTER
NPI 1952966301
Clinic/Center - Federally Qualified Health Center (FQHC) in Los Angeles, CA

Active since May 01, 2019
4137 VERDUGO RD, LOS ANGELES, CA 90065(323) 928-5052 Get Directions Write a Review

NPPES record last updated: April 30, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 30, 2021, May 1, 2019 (2 updates tracked since 2019).

About Tri-state Community Healthcare Center NPPES

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

TRI-STATE COMMUNITY HEALTHCARE CENTER (NPI 1952966301) is a healthcare organization registered as a federally qualified health center (fqhc) in Los Angeles, California and active in the NPI registry since May 2019. The organization lists Crystale Mineros, Managed Care Director, as its authorized official.

NPPES Registry Identity

NPI1952966301
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameTRI-STATE COMMUNITY HEALTHCARE CENTER
Location Address4137 VERDUGO RDLos Angeles, CA 90065-3820
Mailing Address4137 Verdugo RdLos Angeles, CA 90065-3820
Phone(323) 928-5052
Organization SubpartYes
Authorized OfficialCrystale MinerosManaged Care Director · (323) 297-0884
Enumeration DateMay 1, 2019
Last NPPES UpdateApril 30, 20212 updates tracked since enumeration
NPPES CertifiedApril 30, 2021
✔ NPI 1952966301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
4137 VERDUGO RD, Los Angeles, CA 90065
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Other Providers at the Same Location NPPES 6

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

PARVIZ P IMANI MD, INC
General Practice
4137 VERDUGO RD
LOS ANGELES, CA 90065
Los Angeles County (323) 256-5800
HOMIRA OMAR PA
Physician Assistant
4137 VERDUGO RD
LOS ANGELES, CA 90065
Los Angeles County (323) 344-9255
MRS. KATHY LE BALLEK PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
4137 VERDUGO RD
LOS ANGELES, CA 90065
Los Angeles County (323) 344-9255
PERNI MOVSESIAN
Nurse Practitioner (Family)
4137 VERDUGO RD
LOS ANGELES, CA 90065
Los Angeles County (323) 344-9255
ALFRED LUIS CISNEROS M.D.
General Practice
4137 VERDUGO RD
LOS ANGELES, CA 90065
Los Angeles County (323) 344-9255
TRI-STATE COMMUNITY HEALTHCARE CENTER
Clinic/Center (Federally Qualified Health Center (FQHC))
4137 VERDUGO RD
LOS ANGELES, CA 90065
Los Angeles County (323) 344-9255

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 Tri-State Community Healthcare Center's NPI number?

The NPI number for Tri-State Community Healthcare Center is 1952966301. It was assigned to this organization in the NPPES registry on May 1, 2019.

Where is Tri-State Community Healthcare Center located?

Tri-State Community Healthcare Center is located at 4137 Verdugo Rd, Los Angeles, CA 90065. The listed phone number is (323) 928-5052.

What is Tri-State Community Healthcare Center's specialty?

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

When was this NPI record last updated?

The NPPES record for Tri-State Community Healthcare Center was last updated on April 30, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.