OrganizationActive
Via Avanta
NPI 1639610462 · Community Health Clinic/Center · Culver City, CA
Provider details
- NPI number
- 1639610462
- Entity type
- Organization
- Primary specialty
- Community Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Mayli Torres, Assistant Counsler(818) 561-9415
- License
- 172V00000X (CA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(70/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
4760 Sepulveda Blvd
Culver City, CA 90230
Phone: (310) 390-6612
Street-level locationGet directions
Mailing address
4760 Sepulveda Blvd
Culver City, CA 90230
Registry dates
- Enumerated
- 2017-03-13
- Last updated
- 2017-03-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.