SAN JOSE COMMUNITY CLINIC
NPI 1285751024
Clinic/Center in Hawthorne, CA
NPI Status: Active since March 25, 2007
Contact Information
11950 INGLEWOOD AVE
HAWTHORNE, CA
ZIP 90250
Phone: (310) 349-8338
Fax: (310) 349-8340
- Organization
- Clinic/Center
- CLIA Number: 05D1018353
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-19-2025
About SAN JOSE COMMUNITY CLINIC
This page provides the complete NPI Profile along with additional information for San Jose Community Clinic, a provider established in Hawthorne, California operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1285751024 assigned on March 2007. The practitioner's primary taxonomy code is 261Q00000X with license number A055334 (CA). The provider is registered as an organization and their NPI record was last updated 7 years ago. The authorized official of this NPI record is Reza Danesh Md (Ceo)
- NPI
- 1285751024
- Provider Name
- SAN JOSE COMMUNITY CLINIC
- Entity Type
- Organization
- Location Address
- 11950 INGLEWOOD AVE HAWTHORNE, CA 90250
- Location Phone
- (310) 349-8338
- Location Fax
- (310) 349-8340
- Mailing Address
- PO BOX 903 PALOS VERDES ESTATES, CA 90274
- Mailing Phone
- (310) 349-8338
- Mailing Fax
- (310) 349-8340
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-25-2007
- Last Update Date
- 06-18-2018
- Code Navigator
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
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- License No.
- A055334
- License State
- CA
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00A553341 | MEDICAID (05) | CA |
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
- 05D1018353
- Facility Type
- Physician Office
- Certificate Effective Date
- October 20, 2023
- Certificate Expiration Date
- October 19, 2025
- Laboratory Director
- REZA DANESH MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to San Jose Community Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for SAN JOSE COMMUNITY CLINIC
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 8 | 5 | 7 | 5 | 1 | 0 | 2 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 16 | 5 | 14 | 5 | 2 | 0 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 6 + 5 + 1 + 4 + 5 + 2 + 0 + 4 + 24 = 56 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 56 = 4 | 4 | ||||||||
The NPI number 1285751024 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1285751024, enumerated in the NPI registry as an "organization" on March 25, 2007
The provider is located at 11950 Inglewood Ave Hawthorne, Ca 90250 and the phone number is (310) 349-8338
This medical organization specializes in Clinic/Center with taxonomy code 261Q00000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 05D1018353 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on March 25, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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