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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

CLINICA MEDICA SAN JUDAS TADEO
NPI 1962139568
Clinic/Center - Community Health in Huntington Park, CA

Active since August 03, 2022CLIA 05D2301174 · Waiver
2680 E FLORENCE AVE, HUNTINGTON PARK, CA 90255(424) 800-2124 Get Directions Write a Review

NPPES record last updated: August 10, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 10, 2026, Aug 21, 2024, Aug 3, 2022 (3 updates tracked since 2022).

About Clinica Medica San Judas Tadeo NPPES

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

CLINICA MEDICA SAN JUDAS TADEO (NPI 1962139568) is a healthcare organization registered as a community health in Huntington Park, California and active in the NPI registry since August 2022. The organization holds a CLIA Waiver certificate valid through March 20, 2028 and lists Odilia Walsh, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1962139568
Entity TypeOrganization
Primary Taxonomy261QC1500X
Legal Business NameCLINICA MEDICA SAN JUDAS TADEO
Location Address2680 E FLORENCE AVEHuntington Park, CA 90255-4708
Mailing Address2680 E Florence AveHuntington Park, CA 90255-4708 · (424) 800-2124 · Fax (424) 800-2454
Phone(424) 800-2124
Organization SubpartNo
Authorized OfficialOdilia WalshChief Executive Officer · (562) 706-2433
Enumeration DateAugust 3, 2022
Last NPPES UpdateAugust 10, 20263 updates tracked since enumeration
NPPES CertifiedAugust 10, 2026
✔ NPI 1962139568 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Community HealthAmbulatory Health Care Facilities
Taxonomy Code261QC1500X
Also ListedObstetrics & Gynecology · ObstetricsTaxonomy 207VX0000X
2680 E FLORENCE AVE, Huntington Park, CA 90255
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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

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 05D2301174

Clinica Medica San Judas Tadeo · Inglewood, CA
Active · expires Mar 20, 2028
CLIA Number05D2301174
Laboratory TypeCommunity Clinic
Certificate Effective DateMarch 21, 2026
Certificate Expiration DateMarch 20, 2028
Laboratory DirectorRichard Keech
Laboratory Phone(424) 800-2124
Laboratory LocationClinica Medica San Judas Tadeo501 E Hardy Street Ste 110, Inglewood, CA 90301
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

HIGH DESERT WOMENS MEMORIAL MEDICAL CENTER APC
Specialist
2680 E FLORENCE AVE
HUNTINGTON PARK, CA 90255
Los Angeles County (323) 581-4665
SUNDARAM FAMILY MEDICAL CLINIC, INC.
Specialist
2680 E FLORENCE AVE
HUNTINGTON PARK, CA 90255
Los Angeles County (323) 581-4665
FIRSTSOTO MEDICAL GROUP
Family Medicine
2680 E FLORENCE AVE
HUNTINGTON PARK, CA 90255
Los Angeles County (323) 588-4004
DANIEL FREDRICK REID
Nurse Practitioner (Family)
2680 E FLORENCE AVE
HUNTINGTON PARK, CA 90255
Los Angeles County (323) 581-4665

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 Clinica Medica San Judas Tadeo's NPI number?

The NPI number for Clinica Medica San Judas Tadeo is 1962139568. It was assigned to this organization in the NPPES registry on August 3, 2022.

Where is Clinica Medica San Judas Tadeo located?

Clinica Medica San Judas Tadeo is located at 2680 E Florence Ave, Huntington Park, CA 90255. The listed phone number is (424) 800-2124.

What is Clinica Medica San Judas Tadeo's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Community Health, with taxonomy code 261QC1500X.

Does Clinica Medica San Judas Tadeo hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2301174) is associated with this NPI, valid through March 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Clinica Medica San Judas Tadeo was last updated on August 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 days 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.