Provider Demographics
NPI:1861190449
Name:COMMUNITY FAMILY CARE HEALTH PLAN
Entity type:Organization
Organization Name:COMMUNITY FAMILY CARE HEALTH PLAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-282-0288
Mailing Address - Street 1:19210 S VERMONT AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90248-4431
Mailing Address - Country:US
Mailing Address - Phone:310-436-0202
Mailing Address - Fax:310-436-0208
Practice Address - Street 1:1668 S GARFIELD AVE FL 2
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-5400
Practice Address - Country:US
Practice Address - Phone:310-901-7630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization