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FQHCLA298 Centro Medico Community Clinic, Inc. (Active)
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Main Details
Name
Centro Medico Community Clinic, Inc.
Subdivision Name
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-029849
340B ID
FQHCLA298
Grant Number
LALCS00062
Additional Details
Current Program Status
Active
Registration Date
5/22/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/13/2012
Last Recertification Date
2/19/2025
Contacts
Authorizing Official
Centro Medico Community Clinic
Andy Piskoulian, CEO
(951) 278-8910
Primary Contact
Centro Medico CHC
Christine Khatchoyan, Operations Manager
(951) 278-8910 Ext: 133
Addresses
Street Address
1303 W 6th St
105
Corona, CA 92882
Billing Address
Centro Medico Community Clinic
1303 W 6th St
102
Corona, CA 92882
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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