OrganizationActiveAccepts Medicare

Tri-State Community Healthcare Center

NPI 1508379017 · Federally Qualified Health Center (FQHC) · Adelanto, CA

Enrolled with Medicare as Part a Provider - Federally Qualified Health Center (fqhc) · source: CMS PECOS Public Provider Enrollment (2026.04.01)

Provider details

NPI number: 1508379017
Entity type: Organization
Primary specialty: Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Parent organization: Tri-State Community Healthcare Center
Organization subpart: Yes
Authorized official: Crystale Mineros, Credentialing Manager(909) 575-7161

Specialties & taxonomies

Federally Qualified Health Center (FQHC)Primary261QF0400X
Ambulatory Health Care Facilities
Primary Care Clinic/Center261QP2300X
Ambulatory Health Care Facilities

Profile Score

Detailed profile(78/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
8 yrs in NPPES registry
Profile completeness38% of score
100% of core fields populated
Practice footprint23% of score
10 documented practice locations

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Practice location

11499 Bartlett Ave

Adelanto, CA 92301-1902

Phone: (760) 444-4258

Street-level locationGet directions

More CA providers

Mailing address

1535 E Colorado St

Glendale, CA 91205-1513

Additional practice locations (9)

11888 Bartlett Ave
Adelanto, CA 92301-1709
Phone: (760) 530-9944
Fax: (760) 530-9977
540 N San Jacinto St Ste P
Hemet, CA 92543-3154
Phone: (951) 929-4000
Fax: (951) 929-4100
540 N San Jacinto St Ste I
Hemet, CA 92543-3154
Phone: (951) 651-1006
4137 Verdugo Rd
Los Angeles, CA 90065-3820
Phone: (323) 344-9255
Fax: (323) 344-8776
3600 E 1st St
Los Angeles, CA 90063-2326
Phone: (323) 694-0911
Fax: (323) 694-0900
6630 Crenshaw Blvd
Los Angeles, CA 90043-4102
Phone: (213) 686-1517
Fax: (213) 686-1518
1532 San Bernardino Ave Ste B7
Pomona, CA 91767-3559
Phone: (909) 301-4041
1532 San Bernardino Ave Ste A2
Pomona, CA 91767-3559
Phone: (909) 301-4041
Fax: (909) 301-4042

Enumerated: 2017-11-07
Last updated: 2025-09-29
Certified: 2025-09-29

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.