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County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health AssessorsLicense #Last NameFirst NameTitle NPISite 82HIGH DESERT WOMENSMEMORIAL MEDICAL CTR APC2680 E FLORENCE AVE9/11/2019HUNTINGTON PARK 902554708A72880ABBOTTLARA ACCADMD1013199264A NORTHEAST VALLEY HEALTHCORP SUN VALLEY HEALTHCENTER7223 FAIR AVESUN VALLEY 91352-49643/14/20081730180118NORTHEAST VALLEY HEALTHLAC-VALENCIA23763 VALENCIA BLVDVALENCIA 91355-210510/8/20031558693655NORTHEAST VALLEY HEALTH18533 SOLEDAD CANYONRDSANTA CLARITA 91351372210/21/20101235130600NORTHEAST VALLEY HEALTH1600 SAN FERNANDO RDSAN FERNANDO 91340311510/8/20031093716474NORTHEAST VALLEY HEALTHPEDIATRIC HLTH & WIC CTR7138 VAN NUYS BLVDVAN NUYS 91405-300510/8/20031114928595NORTHEAST VALLEY HEALTH12756 VAN NUYS BLVDPACOIMA 91331-169610/8/20031013199264S NORTHEAST VALLEY HEALTHTACORPORATION- MACLAYWELLNESS CTR.12451 W GAIN STREETPACOIMA 913312/23/20211013199264B NORTHEAST VALLEY HEALTHCORP INTERMITTENT7107 REMMET AVE10/8/2003CANOGA PARK 91303-2016188110431323413 LYONS AVESANTA CLARITA 9135530284/12/20181013199264C NORTHEAST VALLEY HEALTHCORPORATION INTERMITTENT11051 N O'MELVENY AVESAN FERNANDO 91340442610/8/2003NORTHEAST VALLEY HEALTHCORPORATIONActive DateA141310ABDALLAHAGUSTIN MMD1982617692CO OF L.A. - ROYBALCOMPREHENSIVE HEALTH245 S FETTERLY AVE7/2/2019LOS ANGELES 90022-1605A36609ABDEL-MALEKSHAHIRA SHAFIK MD1285753723CENTURY WOMEN MEDICALGROUP INC2030 W PICO BLVD7/6/2018LOS ANGELES 90006-5011Tuesday, April 05, 2022Page 1 of 352
County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health AssessorsA36609ABDEL-MALEKSHAHIRA SHAFIK MD1508088840ABDEL- MALEK, SHAHIRA MD INC3100 E FLORENCE AVESTE 1HUNTINGTON PK 9025558489/24/19971558703017CENTURY FAMILY MEDICALGROUP INC16900 LAKEWOOD BLVDSUITE 308BELLFLOWER 90706-55809/12/20186/12/2017A106876ABDELMELEKSAM WELSONMD1922490960AGHABY COMPREHENSIVECOMMUNITY HEALTH CENTER349 W COMPTON BLVDCOMPTON 90220-3110A46128ABDIANLOGHMANMD1710077961L AND P MEDICAL GROUP INC1107 S ALVARADO ST STE 11/13/2000102LOS ANGELES 90006-4161A109793ABDIANPEDRAM SHAWN MD1710077961L AND P MEDICAL GROUP INC1107 S ALVARADO ST STE 2/27/2012102LOS ANGELES BRAHAM, GIZEL A MD1510 S CENTRAL AVE STE 12/6/1999510GLENDALE 8597KEDREN COMMUNITY HEALTHCENTER INC4211 SOUTH AVALON9/17/2021BLVD SUITE ALOS ANGELES 90011-5622RN833467ABRAMIANARIN VAHAN1275545725SERRA COMMUNITY MEDICALCLINIC9375 SAN FERNANDO RDSUN VALLEY 91352-141811/8/20211487298477SFV HEALTH CENTER INC8426 SUNLAND BLVDSUN VALLEY 91352-34361/24/2022NP20A4561ADAMSJOHN DONALD JR DO1508278359THE ROADS FOUNDATION INC121 S LONG BEACH BLVDCOMPTON 90221-34237/7/2016G81919ADHAMIAFSHIN SHAWN1932315827ADHAMI, SHAWN A MD INC1000 W WHITTIER BLVDMONTEBELLO 90640-463910/18/20051104991686ADHAMI, AFSHIN S MD3030 TYLER AVEEL MONTE 91731-335212/25/20001700023942CHAVA, SREEDHAR MD INC3580 SANTA ANITA AVESUITE AEL MONTE 91731-24558/6/20181104163781CHAVA, SREEDHAR MD INC1651 N HACIENDA BLVDLA PUENTE 91744-11373/3/2015RN745674ADLAOTuesday, April 05, 2022MARIROSELANDICHOMDNPPage 2 of 352
County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health 189ADLERROBERTMD1629283197A ALTAMED HEALTH SERVICESCORPORATIONRN608791ADRANEDAALDRINE ALBANP1932428828SOUTHERN CALIFORNIA MEDICAL 8825 WHITTIER BLVDCENTER INCPICO RIVERA 90660-260011/29/20211225357114SOUTHERN CALIFORNIA MED CTR 12100 VALLEY BLVD STE109AEL MONTE 91732-310011/29/20211255729661SOUTHERN CALIFORNIA MEDICAL 14550 HAYNES STCENTER INCVAN NUYS 91411-161311/29/20211730180118NORTHEAST VALLEY HEALTHLAC-VALENCIA23763 VALENCIA BLVDVALENCIA 91355-210512/15/20171558693655NORTHEAST VALLEY HEALTH18533 SOLEDAD CANYONRDSANTA CLARITA 91351372212/15/20171235130600NORTHEAST VALLEY HEALTH1600 SAN FERNANDO RDSAN FERNANDO 91340311512/15/20171013199264A NORTHEAST VALLEY HEALTHCORP SUN VALLEY HEALTHCENTER7223 FAIR AVESUN VALLEY 91352-496412/15/20171114928595NORTHEAST VALLEY HEALTH12756 VAN NUYS BLVDPACOIMA 91331-169612/15/20171093716474NORTHEAST VALLEY HEALTHPEDIATRIC HLTH & WIC CTR7138 VAN NUYS BLVDVAN NUYS 91405-300512/15/2017RN804322ADRIANOTuesday, April 05, 2022MAE KHRISTINEUBALDONPUNIVERSITY MUSLIM MEDICALASSOCIATION INC7821 AVALON BLVD2/26/2020LOS ANGELES 90003-23584650 W SUNSET BLVD 1ST 5/17/2006FLOOR, PAGE BLDGLOS ANGELES 90027-60621013199264B NORTHEAST VALLEY HEALTHCORP INTERMITTENT7107 REMMET AVE12/15/2017CANOGA PARK 91303-20161013199264S NORTHEAST VALLEY HEALTHTACORPORATION- MACLAYWELLNESS CTR.12451 W GAIN STREETPACOIMA 913312/23/20211013199264C NORTHEAST VALLEY HEALTHCORPORATION INTERMITTENT11051 N O'MELVENY AVESAN FERNANDO 91340442612/15/2017Page 3 of 352
County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health AssessorsRN804322ADRIANOMAE GELANPNORTHEAST VALLEY HEALTHCORPORATION23413 LYONS AVESANTA CLARITA 9135530284/12/20181013199264C NORTHEAST VALLEY HEALTHCORPORATION INTERMITTENT11051 N O'MELVENY AVESAN FERNANDO 9134044262/8/2022188110431323413 LYONS AVESANTA CLARITA 9135530282/8/2022NORTHEAST VALLEY HEALTHCORPORATION1013199264B NORTHEAST VALLEY HEALTHCORP INTERMITTENT7107 REMMET AVE2/8/2022CANOGA PARK 91303-20161013199264S NORTHEAST VALLEY HEALTHTACORPORATION- MACLAYWELLNESS CTR.12451 W GAIN STREETPACOIMA 913312/8/20221093716474NORTHEAST VALLEY HEALTHPEDIATRIC HLTH & WIC CTR7138 VAN NUYS BLVDVAN NUYS 91405-30052/8/20221114928595NORTHEAST VALLEY HEALTH12756 VAN NUYS BLVDPACOIMA 91331-16962/8/20221013199264A NORTHEAST VALLEY HEALTHCORP SUN VALLEY HEALTHCENTER7223 FAIR AVESUN VALLEY 91352-49642/8/20221235130600NORTHEAST VALLEY HEALTH1600 SAN FERNANDO RDSAN FERNANDO 9134031152/8/20221558693655NORTHEAST VALLEY HEALTH18533 SOLEDAD CANYONRDSANTA CLARITA 9135137222/8/20221730180118NORTHEAST VALLEY HEALTHLAC-VALENCIA23763 VALENCIA BLVDVALENCIA N SANTOS NP1508872912CO OF L.A. - WILMINGTONSUBCENTER1325 BROAD AVEWILMINGTON 90744-2604RN445890AGBOOKWII G1942756937CITY MEDICAL GROUP INC1508 E. FLORENCE3/15/2021AVENUELOS ANGELES 90001-2536Tuesday, April 05, 2022NPPage 4 of 352
County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health AssessorsRN639277AGLUGUBJAIME LACARANP1487086989CENTRAL NEIGHBORHOODHEALTH FOUNDATION2614 S GRAND AVENUELOS ANGELES, CA 9000726078/1/2017C51785AGRAWALGYANESHMD1649383464S CO OF L.A. - SOUTH VALLEY PEDTASATELLITE CLINIC38350 40TH STREET EAST 3/4/2013SUITE 200PALMDALE 93552-30751649383464CO OF L.A. - SOUTH VALLEYHEALTH CTR38350 40TH ST E STE 100PALMDALE CS MEDICAL CORPORATIONFAMILY CARE SPECIALISTS1701 E CESAR E CHAVEZ 11/25/2015AVE STE 230LOS ANGELES 90033-2496G66921AGUILARDAVID GILBERTMD1730291287AGUILAR, DAVID G MD7705 SEVILLE AVE STE DHUNTINGTON PARK, CA90255A64940AGUILARFELIXMD1427046754CHINATOWN SERVICE CENTERFAMILY HEALTH CLINIC767 N HILL ST., STE 2002/9/2021LOS ANGELES VENICE FAMILY CLINIC604 ROSE AVEVENICE 90291-27671/18/2018PA22413AGUILARVALERIE RAQUEL PA1669418513VENICE FAMILY CLINIC604 ROSE AVEVENICE DO1851306724AGUILUZ, JACQUELINE B DOTOWNE CENTER FAMILY MED21508 NORWALK BLVDHAWAIIAN A CNP1750469318SGHIATTI, VINCENT R APC6316 HOLMES AVE5/13/2013LOS ANGELES 90001-1824A126281AHANKOOBNONAMD1225357114SOUTHERN CALIFORNIA MED CTR 12100 VALLEY BLVD STE109AEL MONTE 91732-31005/1/20191255729661SOUTHERN CALIFORNIA MEDICAL 14550 HAYNES STCENTER INCVAN NUYS 91411-16135/20/2019A111521AHDOOTTuesday, April 05, 2022DAFNAMD5/16/20161801921952A ROY MEDICAL GROUP INC16063 VANOWEN STVAN NUYS 91406-48107/3/20191801921952B ROY MEDICAL GROUP INC21001 SHERMAN WAY STE 11/26/201415CANOGA PARK 91303-1760Page 5 of 352
County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health AssessorsA111521AHDOOTDAFNAMD1801921952E ROY MEDICAL GROUP INC8001 LAUREL CANYONBLVD STE 109NORTH 197A ALTAMED HEALTH SERVICESCORPORATION4650 W SUNSET BLVD 1ST 3/19/2019FLOOR, PAGE BLDGLOS ANGELES 90027-6062A164190AHMEDAMEERMD1730481318ALTAMED HEALTH SERVICESCORPORATION1300 S SUNSET AVE2/23/2021WEST COVINA 91790-3342A101248AHMEDRASIQ ABDULJABBARMD1942416045MENDOZA, MANUEL F MD INC16660 PARAMOUNT BLVD306PARAMOUNT 90723-5459A92596AHMEDTAHA MOHAMEDMD1962069393ST JOHN COMMUNITY HEALTHCENTER2112 S GAREY AVE STE C 9/14/2021POMONA IAN, IGHIA MD APC1510 SOUTH CENTRALAVE SUITE 450GLENDALE 1710084959AIYEGBUSI AND BRAIMAH AMC3661 TORRANCE BLVDSTE 103TORRANCE A AKHAVAN, AFSHIN DO APROFESSIONAL CORPORATION2409 S VERMONT AVE9/20/2005LOS ANGELES 90007-16611821210329B AKHAVAN, AFSHIN DO A530 E WASHINGTON BLVD 7/21/2011LOS ANGELES 90015-37231730481318ALTAMED HEALTH SERVICESCORPORATION1300 S SUNSET AVE8/21/2018WEST COVINA 91790-33421346607603UNIFIED CARE MEDICAL GROUPINC2040 PACIFIC COAST HWY 4/20/2021UNIT SLOMITA 90717-26601386934875PEDIATRIC AND FAMILY MEDICAL 1400 SOUTH GRAND AVE 11/6/2019CENTERSTE 101LOS ANGELES ODUPEOLUWATOYINMOFESOLANPMD9/3/20201982075107A PEDIATRIC AND FAMILY MEDICAL 15477 VENTURA BLVDCENTERSUITE 300SHERMAN OAKS 914033006Tuesday, April 05, 202210/13/201112/4/2019Page 6 of 352
County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health AssessorsRN498018AKINWOLEYEMI KAYODENP1801154463TOTAL CARE MEDICAL CLINIC INC 1110 W ANAHEIM ST STE 6 10/11/2018WILMINGTON 90744-4131A122651AL ATASSIKAOSAR DALIAMD1083003321A WHITE MEMORIAL COMMUNITYHEALTH CENTER1828 E CESAR E CHAVEZ 8/24/2017AVE SUITE 5000LOS ANGELES 90033-24961083003321B WHITE MEMORIAL COMMUNITYINTERMITTENT1828 E CESAR E CHAVEZ 3/17/2021SUITE 4300LOS ANGELES SIVE COMMUNITYHEALTH CTR-NO HOLLYWOOD12157 VICTORY BLVD7/25/2002N HOLLYWOOD 91606-3204C152422AL-AHMADLAMISMD1164061461SEQUOIA QUALITY HEALTH INC2007 WILSHIRE BLVD FL 3, 12/3/20201ALOS ANGELES 56938S LAC USC MEDICAL CENTER TBOUTPATIENT PEDIATRIC DEPT.2010 ZONAL AVE OPD 511/30/2016EASTLOS ANGELES 133 N PRAIRIE AVE STE BINGLEWOOD A REYESNP1013199264C NORTHEAST VALLEY HEALTHCORPORATION INTERMITTENT11051 N O'MELVENY AVESAN FERNANDO 9134044266/29/2005188110431323413 LYONS AVESANTA CLARITA 9135530284/12/2018Tuesday, April 05, 2022ALBURY, DENISE A MD INCNORTHEAST VALLEY HEALTHCORPORATION1013199264B NORTHEAST VALLEY HEALTHCORP INTERMITTENT7107 REMMET AVE6/29/2005CANOGA PARK 91303-20161013199264S NORTHEAST VALLEY HEALTHTACORPORATION- MACLAYWELLNESS CTR.12451 W GAIN STREETPACOIMA 913312/23/20211013199264A NORTHEAST VALLEY HEALTHCORP SUN VALLEY HEALTHCENTER7223 FAIR AVESUN VALLEY 91352-49643/14/20081235130600NORTHEAST VALLEY HEALTH1600 SAN FERNANDO RDSAN FERNANDO 9134031156/29/20051730180118NORTHEAST VALLEY HEALTHLAC-VALENCIA23763 VALENCIA BLVDVALENCIA 91355-21056/29/2005Page 7 of 352
County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health AssessorsRN289658ALCANTARAFERNANDEZROWENA REYESNP1558693655NORTHEAST VALLEY HEALTH18533 SOLEDAD CANYONRDSANTA CLARITA 91351372210/21/20101114928595NORTHEAST VALLEY HEALTH12756 VAN NUYS BLVDPACOIMA 91331-16966/29/20051093716474NORTHEAST VALLEY HEALTHPEDIATRIC HLTH & WIC CTR7138 VAN NUYS BLVDVAN NUYS 91405-30056/29/2005EAST VALLEY COMM HLTH420 S GLENDORA AVE12/6/2021WEST COVINA 91790-3001RN805621ALCIDJULIE ANNENP1831243625A119750ALFONSOKAREN KAYGRAGASINMD1205167350B MEMORIALCARE MEDICALFOUNDATION22719 HAWTHORNE BLVDTORRANCE 90505-36132/3/2020A50859ALIALIYA IMRANMD196251384612826 PHILADELPHIA STSTE AWHITTIER 67490425B HARBOR COMMUNITY CLINIC, INC 425 S PACIFIC AVESAN PEDRO 907314/22/2021C51874ALLEYNEROBIN ANDREWMD1043462443CLINICA FAMILIAR SAN LUCAS11050 S ATLANTIC AVELYNWOOD 90262-30684/30/2021RN698861ALUNANPATRICK SNP1538278270AZURIN, ELEANOR MD INC3045 E FLORENCE AVEHUNTINGTON PK 9025558372/23/2017PA57194ALVARADOCARLOS DEJESUSPA1093023277UNIVERSAL COMMUNITY HEALTH 1005 E WASHINGTON6/5/2020CENTERBLVD STE ALOS ANGELES 90021-30201932757820UNIVERSAL COMMUNITY HEALTH 2098 S CENTRAL AVE4/22/2021INTERMITTENTLOS ANGELES 90011-12351174913776UNIVERSAL COMMUNITY HEALTH 2801 SOUTH SAN PEDRO 6/5/2020STLOS ANGELES 90011-2023ALI, ALIYA I MDPA55748ALVAREZRACHAELREBUJIOPA1245383488AUSTIN, EDWARD MD1331 E COMPTON BLVDCOMPTON 90221-3401A144136ALVAREZCASILLASVICTOR HUGOMD1164668786PREMIER FAMILY MEDICINEASSOCIATES, INC1601 N MONTE VISTA AVE 8/29/2017STE 100CLAREMONT 91711-6601Tuesday, April 05, 20226/15/2020Page 8 of 352
County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health AssessorsA144136ALVAREZCASILLASVICTOR HUGOMD1912907114PREMIER FAMILY MEDICINEASSOCIATES INC20A13338ALVIRMARJORIE ANNE DO1982814745ALTAMED COMM HEALTH CLIN EL 10418 VALLEY BLVD STEMONTEBEL MONTE 91731-2402RN498049ALWANIRN95130198 AMAYASHIREENJESSICA PAOLANPNP1770 N ORANGE GROVEAVE STE 101POMONA 91767-30274/21/20217/16/20201629283197A ALTAMED HEALTH SERVICESCORPORATION4650 W SUNSET BLVD 1ST 9/26/2019FLOOR, PAGE BLDGLOS ANGELES 90027-60621457744476COMMUNITY MEDICINE, INC8540 ALONDRA BLVDSUITE B-2PARAMOUNT 90723-52009/6/20171497397806COMMUNITY MEDICINE, INCINTERMITTENT8800 ALONDRA BLVDSUITE CBELLFLOWER 90706-430210/14/20201316044522EISNER PEDIATRIC AND FAMILYMEDICAL CENTER1530 S OLIVE ST8/18/2017LOS ANGELES 90015-30231386934875PEDIATRIC AND FAMILY MEDICAL 1400 SOUTH GRAND AVE 7/7/2020CENTERSTE 101LOS ANGELES 90015-30231982075107A PEDIATRIC AND FAMILY MEDICAL 15477 VENTURA BLVDCENTERSUITE 300SHERMAN OAKS 9140330061/18/2018RN95106058 AMBRIZSONYANP1477069375GAGE MEDICAL CLINIC INC. R OFHUNTINGTON PARK3203 E FLORENCE AVE11/29/2021HUNTINGTON PARK 902555831A40490AMINJAYMD1861711863AME MEDICAL GROUP INC11938 PARAMOUNT BLVD. 5/13/2020DOWNEY 90242-2306PA16689ANABOARVIN ALMAZANPA1649324443EAST VALLEY COMMUNITYHEALTH CENTER INC.1555 SOUTH GAREY AVEPOMONA 91766-5222A163145ANANTHMINA PARVATIMD1083003321A WHITE MEMORIAL COMMUNITYHEALTH CENTER1828 E CESAR E CHAVEZ 12/3/2020AVE SUITE 5000LOS ANGELES 90033-24961083003321B WHITE MEMORIAL COMMUNITYINTERMITTENT1828 E CESAR E CHAVEZ 3/17/2021SUITE 4300LOS ANGELES 90033-2400Tuesday, April 05, 20226/26/2020Page 9 of 352
County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health DINAMDMIGUEL ANGELPA1467465641S CO OF L.A. - MID VALLEY COMPTAHC7515 VAN NUYS BLVDVAN NUYS 91405-19499/19/201712755918021920 COLORADO AVESANTA MONICA 9040434149/1/2016UC REGENTS UCLA FAMILYHEALTH CENTER1255542601A ALTAMED MEDICAL - DENTALGROUP, WHITTIER WEST3945 WHITTIER BLVD4/27/2006LOS ANGELES 90023-24401255542601C ALTAMED MEDICAL AND DENTAL- 1305 S CONCORD STREET 10/8/2007ESTRADA COURTSSTE 18LOS ANGELES 90023-35031255542601D ALTAMED MEDICAL ANDDENTAL/RAMONA GARDENS1424 CRUSADO LANE STE 12/6/2007168LOS ANGELES 90033-15121255542601B ALTAMED MEDICAL AND DENTAL - 268 E BLOOM STREET STE 12/19/2007WILLIAMS MEAD322LOS ANGELES 90012-1973PA14668ANDALIEDAPA1114928595NORTHEAST VALLEY HEALTH12756 VAN NUYS BLVDPACOIMA 91331-16961/26/20071093716474NORTHEAST VALLEY HEALTHPEDIATRIC HLTH & WIC CTR7138 VAN NUYS BLVDVAN NUYS 91405-30051/26/20071013199264A NORTHEAST VALLEY HEALTHCORP SUN VALLEY HEALTHCENTER7223 FAIR AVESUN VALLEY 91352-49643/14/20081235130600NORTHEAST VALLEY HEALTH1600 SAN FERNANDO RDSAN FERNANDO 9134031151/26/20071558693655NORTHEAST VALLEY HEALTH18533 SOLEDAD CANYONRDSANTA CLARITA 91351372210/21/20101730180118NORTHEAST VALLEY HEALTHLAC-VALENCIA23763 VALENCIA BLVDVALENCIA 91355-21051/26/200711051 N O'MELVENY AVESAN FERNANDO 9134044261/26/20071013199264C NORTHEAST VALLEY HEALTHCORPORATION INTERMITTENTTuesday, April 05, 2022Page 10 of 352
County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health TUMBLINMDG48857ANDERSONMARTIN MATHEW MD1881104313NORTHEAST VALLEY HEALTHCORPORATION4/12/20181013199264B NORTHEAST VALLEY HEALTHCORP INTERMITTENT7107 REMMET AVE1/26/2007CANOGA PARK 91303-20161013199264S NORTHEAST VALLEY HEALTHTACORPORATION- MACLAYWELLNESS CTR.12451 W GAIN STREETPACOIMA 913312/23/20211629283197B ALTAMED HEALTH SERVICESINTERMITTENT2100 WEST 3RD STREETSTE. 200LOS ANGELES 900578/16/20191558693655NORTHEAST VALLEY HEALTH18533 SOLEDAD CANYONRDSANTA CLARITA 91351372210/21/20101730180118NORTHEAST VALLEY HEALTHLAC-VALENCIA23763 VALENCIA BLVDVALENCIA 91355-21054/10/20011235130600NORTHEAST VALLEY HEALTH1600 SAN FERNANDO RDSAN FERNANDO 9134031153/19/20011013199264A NORTHEAST VALLEY HEALTHCORP SUN VALLEY HEALTHCENTER7223 FAIR AVESUN VALLEY 91352-49643/14/20081982667663UCLA DEPT OF PEDIATRICS GRPPRACTICE200 UCLA MED PLAZA5/11/1999CHILDRENS HLTH CTRSTE 265LOS ANGELES 90095-30751093716474NORTHEAST VALLEY HEALTHPEDIATRIC HLTH & WIC CTR7138 VAN NUYS BLVDVAN NUYS 91405-30052/5/20021114928595NORTHEAST VALLEY HEALTH12756 VAN NUYS BLVDPACOIMA 91331-16963/19/20011124054564VENICE FAMILY CLINIC- ROBERTLEVINE FAM HEALTH905 VENICE BLVDVENICE 90291-49046/29/201511051 N O'MELVENY AVESAN FERNANDO 9134044263/2/19891013199264C NORTHEAST VALLEY HEALTHCORPORATION INTERMITTENTTuesday, April 05, 202223413 LYONS AVESANTA CLARITA 913553028Page 11 of 352
County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health RSONMARTIN MATHEW MDPATRICIANATALIENP1881104313NORTHEAST VALLEY HEALTHCORPORATION23413 LYONS AVESANTA CLARITA 9135530284/12/20181013199264S NORTHEAST VALLEY HEALTHTACORPORATION- MACLAYWELLNESS CTR.12451 W GAIN STREETPACOIMA 913312/23/20211013199264B NORTHEAST VALLEY HEALTHCORP INTERMITTENT7107 REMMET AVE3/19/2001CANOGA PARK 91303-20161124106646LANARK FAMILY MED CLINIC8040 VAN NUYS BLVDPANORAMA CITY 9140260101316455363YASHARPOUR MEDICAL DOCTOR, 7400 VAN NUYS BLVD.,INC., APMCSTE 120VAN NUYS 91405-19727/1/20191255849238YASHARPOUR MEDICAL DOCTOR, 6330 VAN NUYS BLVDINC APMCVAN NUYS 67479ALTAMED HEALTH SERVICESCORPORATION8627 ATLANTIC AVENUESOUTH GATE 90280-3501RN95079674 ANDRADEJACQUELINENP1790177582ALTAMED HEALTH SERVICESCORPORATION1900 E SLAUSON AVE9/14/2021HUNTINGTON PARK 902552725A134344ANDRADERIA R.MD1770988370JWCH INSTITUTE INC8530 FIRESTONE BLVDDOWNEY 90241-49268/24/2016A54706ANDRESBLANCA GENAMD1669418513VENICE FAMILY CLINIC604 ROSE AVEVENICE 90291-27679/24/20021124054564VENICE FAMILY CLINIC- ROBERTLEVINE FAM HEALTH905 VENICE BLVDVENICE 90291-49046/29/2015ALTAMED HEALTH SERVICESCORPORATION8627 ATLANTIC AVENUESOUTH GATE 90280-35019/14/2021A125066ANGULOMARCO ANTONIO MD1902267479C41801ANTONIOADELAIDABRINAS1801921952B ROY MEDICAL GROUP INC21001 SHERMAN WAY STE 6/7/201115CANOGA PARK 91303-17601801921952A ROY MEDICAL GROUP INC16063 VANOWEN STVAN NUYS 91406-481013362082551530 HILLHURST AVE8/23/2018LOS ANGELES 90027-551620A13819ANTOSSYANTuesday, April 05, 2022MERIMDDOASIAN PACIFIC HEALTH CAREVENTURE, INC7/3/2019Page 12 of 352
County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health Assessors20A13819ANTOSSYANMERIDO1003951708ASIAN PACIFIC HLTH CARE INC3939 TRACY ST8/23/2018LOS ANGELES 90027-3207PA19004APARICIOJUAN CARLOSPA1477069375GAGE MEDICAL CLINIC INC. R OFHUNTINGTON PARK3203 E FLORENCE AVE11/29/2021HUNTINGTON PARK 9025558311003053943GAGE MEDICAL CLINIC INC985 W VERNON AVE1/25/2016LOS ANGELES 90037-3038A44427ARASTUANWAR HUSAINMD1831493394ANWAR AND VASEEMA ARASTUMD INC12675 LA MIRADA BLVDSTE 200LA MIRADA 1493394ANWAR AND VASEEMA ARASTUMD INC12675 LA MIRADA BLVDSTE 200LA MIRADA 83CO OF L.A. - LITTLEROCKCOMMUNITY CLN8201 PEARBLOSSOM HWY 12/12/2012LITTLEROCK 93543-30421336152578CO OF L.A. - ANTELOPE VALLEYHLTH CTR335 E AVENUE K6 STE BLANCASTER 93535-46455/9/20071649383464S CO OF L.A. - SOUTH VALLEY PEDTASATELLITE CLINIC38350 40TH STREET EAST 1/17/2013SUITE 200PALMDALE 93552-30751649383464CO OF L.A. - SOUTH VALLEYHEALTH CTR38350 40TH ST E STE 100PALMDALE 93552-30751821101643CO OF L.A. - LAKE LA COMMUNITY 16921 E AVENUE O SPC G 1/23/2004CLINICPALMDALE 93591-304511/20/20021003929829A CO OF L.A. - HIGH DESERTHEALTH SYSTEMS335 EAST AVENUE ILANCASTER 93535-19165/9/20071003929829B CO OF L.A.- HIGH DESERT RGNLHLTH CTR, SCAN/HUB335 EAST AVENUE ILANCASTER 93535-19165/9/20074055 WHITTIER BLVD6/19/1992LOS ANGELES 90023-2536A35390ARBIDMASAD 26642B LAKESIDE MEDICAL191 S BUENA VISTASTREET SUITE 200-240BURBANK 2431217 W WHITTIER BLVDMONTEBELLO 90640-46423/29/2011Tuesday, April 05, 2022SAN MATEO MEDICAL CLINIC INCMODERN CONCEPTS MED GRPPage 13 of 352
County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health LARKJANET SUZANNE MD1245343052S CO OF L.A. - MARTIN LUTHERTAKING, JR/DREW MEDICAL CTR1721 E 120TH STREETLOS ANGELES 90059PA15146AROCHEMAYRA LPA1942255195FCS MEDICAL CORPORATIONFAMILY CARE SPECIALISTS1701 E CESAR E CHAVEZ 12/11/2007AVE STE 230LOS ANGELES 90033-2496A131380AROMINMELISSA JOMD1770006728ALTAMED HEALTH SERVICESCORPORATION972 GOODRICH BLVDCOMMERCE REHENSIVE COMMUNITYHEALTH CTR-EAGLE ROCK1704 COLORADO BLVD8/29/2016LOS ANGELES 90041-1338G48417ARROYOMANUELMD1720196702HIGH DESERT MEDICAL GRP INC43839 15TH ST WLANCASTER ORTHEAST VALLEY HEALTH12756 VAN NUYS BLVDPACOIMA 91331-16969/15/20171093716474NORTHEAST VALLEY HEALTHPEDIATRIC HLTH & WIC CTR7138 VAN NUYS BLVDVAN NUYS 91405-30059/15/20171730180118NORTHEAST VALLEY HEALTHLAC-VALENCIA23763 VALENCIA BLVDVALENCIA 91355-21059/15/20171558693655NORTHEAST VALLEY HEALTH18533 SOLEDAD CANYONRDSANTA CLARITA 9135137229/15/20171235130600NORTHEAST VALLEY HEALTH1600 SAN FERNANDO RDSAN FERNANDO 9134031159/15/20171013199264A NORTHEAST VALLEY HEALTHCORP SUN VALLEY HEALTHCENTER7223 FAIR AVESUN VALLEY 91352-49649/15/20171013199264S NORTHEAST VALLEY HEALTHTACORPORATION- MACLAYWELLNESS CTR.12451 W GAIN STREETPACOIMA 913312/23/20211013199264B NORTHEAST VALLEY HEALTHCORP INTERMITTENT7107 REMMET AVE9/15/2017CANOGA PARK 91303-2016Tuesday, April 05, 2022MD1386859619MODERN CONCEPTS MED GRPINC1701 CESAR CHAVEZ AVE 8/23/2011STE 354LOS ANGELES 90033-00005/1/20191/18/2022Page 14 of 352
County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health AssessorsA129850PA19458ARUNRUTASANOVATuesday, April 05, 2022TEDAELENAMDPA1013199264C NORTHEAST VALLEY HEALTHCORPORATION INTERMITTENT11051 N O'MELVENY AVESAN FERNANDO 9134044269/15/20171881104313NORTHEAST VALLEY HEALTHCORPORATION23413 LYONS AVESANTA CLARITA 9135530284/12/20181093716474NORTHEAST VALLEY HEALTHPEDIATRIC HLTH & WIC CTR7138 VAN NUYS BLVDVAN NUYS 91405-300510/4/20101114928595NORTHEAST VALLEY HEALTH12756 VAN NUYS BLVDPACOIMA 91331-169610/4/20101235130600NORTHEAST VALLEY HEALTH1600 SAN FERNANDO RDSAN FERNANDO 91340311510/4/20101538130893EL PROYECTO DEL BARRIO INCWINNETKA CLINIC20800 SHERMAN WAYWINNETKA 91306-270712/2/20101558693655NORTHEAST VALLEY HEALTH18533 SOLEDAD CANYONRDSANTA CLARITA 91351372210/4/20101730180118NORTHEAST VALLEY HEALTHLAC-VALENCIA23763 VALENCIA BLVDVALENCIA 91355-210510/4/20101013199264A NORTHEAST VALLEY HEALTHCORP SUN VALLEY HEALTHCENTER7223 FAIR AVESUN VALLEY 91352-496410/4/20101013199264B NORTHEAST VALLEY HEALTHCORP INTERMITTENT7107 REMMET AVE10/4/2010CANOGA PARK 91303-20161013199264S NORTHEAST VALLEY HEALTHTACORPORATION- MACLAYWELLNESS CTR.12451 W GAIN STREETPACOIMA 913312/23/20211013199264C NORTHEAST VALLEY HEALTHCORPORATION INTERMITTENT11051 N O'MELVENY AVESAN FERNANDO 91340442610/4/2010188110431323413 LYONS AVESANTA CLARITA 9135530284/12/2018NORTHEAST VALLEY HEALTHCORPORATIONPage 15 of 352
County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health AssessorsA49733ASHBURNNORMAN KEITHMD1184655730ASHBURN, NORMAN K MD INC2211 WEST MAGNOLIABLVD STE 210BURBANK JWCH INSTITUTE, INC JWCHNORWALK REGIONAL12360 FIRESTONE BLVDNORWALK 89TARZANA TREATMENT CENTERFAMILY MEDICAL CLINIC8330 RESEDA BLVDNORTHRIDGE 91324-461912/22/2021A71831ASNANIMONICA GULMD1639172372CEDARS-SINAI MEDICAL CENTER 8700 BEVERLY BLVD., RM 2/23/20041473LOS ANGELES 90048-1804C154956ASSADIKHATEREH AMD1720571789UNICARE COMMUNITY HEALTHAFFILIATEDA121879ATALLAMARTA IMAMD1255729661SOUTHERN CALIFORNIA MEDICAL 14550 HAYNES STCENTER INCVAN NUYS 91411-161311/29/20211356963417ATALLA MEDICAL GROUP5/11/20211932428828SOUTHERN CALIFORNIA MEDICAL 8825 WHITTIER BLVDCENTER INCPICO RIVERA 90660-260011/29/20211225357114SOUTHERN CALIFORNIA MED CTR 12100 VALLEY BLVD STE109AEL MONTE 91732-310011/29/2021741 S ALVARADO ST2/1/2021LOS ANGELES 90057-2903557 N. MACLAY AVESAN FERNANDO 913402424RN95035566 ATIMANISHANP1336281179A THE LOS ANGELES FREE CLINICHOLLYWOOD WILSHIRE HLTH5205 MELROSE AVE3/19/2019LOS ANGELES 90038-3144A167093ATISPATRICKDUCLAIRMD1770006728972 GOODRICH BLVDCOMMERCE 90022-41141/18/2022RN477277AUBREYCECILIA REYESNP1679570980S LOS ANGELES USD- PANORAMATNS.E.P.A. CLINIC8015 VAN NUYS BLVDPANORAMA 914023/19/20201679570980S LOS ANGELES USD- 2ND STTDELEMANTARY SCHOOL CLINIC1942 EAST 2ND STLOS ANGELES 900337/7/20201679570980S LOS ANGELES USD TCHOLLYWOOD HIGH SCHOOLCLINIC1530 N ORANGE DR.LOS ANGELES 900287/7/20201679570980S LOS ANGELES USD - SEPATBCENTER1339 ANGELINA STLOS ANGELES 900267/7/2020Tuesday, April 05, 2022ALTAMED HEALTH SERVICESCORPORATIONPage 16 of 352
County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health day, April 05, 2022CECILIA REYESMOELIEZLDIMARANANNPMDNP1679570980S LOS ANGELES USD - FOSHAYTAHEALTH CTR3751 S. HARVARD BLVDLOS ANGELES 900187/7/20201679570980S LOS ANGELES USD- KENNEDYTMHIGH SCHOOL CLINIC11254 GOTHICGRANADA HILLS 913443/22/20201679570980S LOS ANGELES USD- ZELZAHTLWELLNESS CLINIC6505 ZELZAH AVERESEDA 913353/2/20201679570980S LOS ANGELES USD- COLUMBUSTISCHOOL BASED CLINIC7739 FARRALONE AVENUE 3/2/2020CANOGA PARK 913041679570980S LOS ANGELES USD- COLUMBUSTISCHOOL BASED CLINIC7739 FARRALONE AVENUE 7/7/2020CANOGA PARK 913041679570980S LOS ANGELES USD-TELFAIRTKHEALTH CLINIC10911 TELFAIR AVEPACOIMA 913313/2/20201679570980S LOS ANGELES USD- LAWRENCETJMIDDLE SCHOOL CLINIC10100 VARIEL AVECHATSWORTH 913113/2/20201679570980S LOS ANGELES USD - MURCHISON 1501 MURCHISON STTEELEMANTARY SCHOOL HEALTHLOS ANGELES 90033CLINIC7/7/20201679570980S LOS ANGELES USD- SAN MIGUELTHHEALTHY START CLINIC7/7/20209801 SAN MIGUEL AVESOUTH GATE 902801679570980S LOS ANGELES USD2510 E. 6THTFROOSEVELT/HOLLENBECK CLINIC LOS ANGELES 900237/7/20201679570980S LOS ANGELES USD-HOLMESTGSCHOOL BASED CLINIC7/7/20205108 HOLMES AVELOS ANGELES 900581104075282QUEENSCARE HEALTH CENTERS 4816 EAST THIRD STREET 11/22/2019LOS ANGELES 90022-16021639241888QUEENSCARE HEALTH CENTERS- 4618 FOUNTAIN AVE11/22/2019HOLLYWOODLOS ANGELES 90029-18301801967062QUEENSCARE HEALTH CENTERS 4448 YORK BLVD11/22/2019LOS ANGELES 90041-33281013083666QUEENSCARE HEALTH CENTERS LOS ANGELES 90026-4656 11/22/20191740835743QUEENSCARE HEALTH CENTERS 303 LOMA DR SUITE 2028/4/2020INTERMITTENTLOS ANGELES 90017-11031134668304TENDER CARE COMMUNITYCLINIC INC7862 FIRESTONE BLVDDOWNEY 90241-422112/4/2019Page 17 of 352
County of Los Angeles - Department of Public HealthChild Health And Disability Prevention ProgramActive Health 5PEDIATRIC AND FAMILY MEDICAL 1400 SOUTH GRAND AVE 11/30/2012CENTERSTE 101LOS ANGELES 90015-3023G66313AUSTINEDWARDMD1245383488AUSTIN, EDWARD MDRN624885AVILAMELDY YIRANYNP1205859733B SANCHEZ, DENNIS J MDSANCHEZ MEDICAL IC AND FAMILY MEDICAL 1400 SOUTH GRAND AVE 11/30/2012CENTERSTE 101LOS ANGELES 90015-3023A76844AWADAALI MOHAMADMD1356531297AWADA, ALI MD INC12301 S HAWTHORNEBLVDHAWTHORNE 90250-2369A106240AYADMARIANNEBOTROSMD1225188204ST ANTHONY MEDICAL CTRIMPERIAL CLINIC837 W IMPERIAL HWY4/29/2016LOS ANGELES 90044-41101952451031ST ANTHONY MEDICAL CTR PICO 2515 W PICO BLVD4/29/2016CLINICLOS ANGELES 90006-40031331 E COMPTON BLVDCOMPTON 90221-34018/7/19983529 FIRESTONE BLVDSOUTH GATE EMATILDENP1982814745ALTAMED COMM HEALTH CLIN EL 10418 VALLEY BLVD STEMONTEBEL MONTE , AYAT MD7232 VAN NUYS BLVD STE 11/2/2010201VAN NUYS 91405-2231A121880AZARNICOLA FARISMD1811397888COMPLETE CARE COMMUNITYHEALTH CENTER INC5831 FIRESTONE BLVDSUITE ESOUTH GATE P1679570980S LOS ANGELES USD- PANORAMATNS.E.P.A. CLINIC8015 VAN NUYS BLVDPANORAMA 914022/17/20221679570980S LOS ANGELES USD - FOSHAYTAHEALTH CTR3751 S. HARVARD BLVDLOS ANGELES 900182/17/20221679570980S LOS ANGELES USD - SEPATBCENTER1339 ANGELINA STLOS ANGELES 900262/17/20221679570980S LOS ANGELES USD TC
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