PEDIATRIC AND FAMILY MEDICAL CENTER: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- PEDIATRIC AND FAMILY MEDICAL CENTER (EIN 95-1690966)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-01-27
- IRS object ID
- 201530279349300418
- Schema version
- 2013v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-01-27T10:58:09-06:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 951777440 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREEN HASSON & JANKS LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10990 WILSHIRE BLVD 16TH FLOOR | AddressLine1 |
| City | LOS ANGELES | City |
| State | CA | State |
| ZIP Code | 900243929 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 951690966 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEDIATRIC & FAMILY MEDICAL CENTER DBA | BusinessNameLine1 |
| Business Name Line2 | EISNER PEDIATRIC & FAMILY MEDICAL CENTER | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PEDI | BusinessNameControlTxt |
| Phone | 2137461037 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1530 SOUTH OLIVE STREET | AddressLine1 |
| City | LOS ANGELES | City |
| State | CA | State |
| ZIP Code | 90015 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | HERB SCHULTZ | PersonNm |
| Person Title | PRESIDENT/CEO | PersonTitleTxt |
| Phone | 2137461037 | PhoneNum |
| Signature | 2015-01-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RICHARD L RUVELSON | PreparerPersonNm |
| PTIN | P00234075 | PTIN |
| Phone | 3108731600 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EISNER PEDIATRICS & FAMILY MED CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | HERB SCHULTZ | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1530 SOUTH OLIVE STREET | AddressLine1 |
| City | LOS ANGELES | City |
| State | CA | State |
| ZIP Code | 90015 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $25,407,865 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PEDCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1920 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | IMPROVE THE PHYSICAL, SOCIAL & EMOTIONAL WELL-BEING OF LOS ANGELES FAMILIES | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 347 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,837,509 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,845,794 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,676,168 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $20,551,998 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,695 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,137 | CYInvestmentIncomeAmt |
| PY Other Revenue | $13,254 | PYOtherRevenueAmt |
| CY Other Revenue | $8,936 | CYOtherRevenueAmt |
| PY Total Revenue | $27,528,626 | PYTotalRevenueAmt |
| CY Total Revenue | $25,407,865 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $16,955,943 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $18,461,724 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $211,631 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,990,504 | PYOtherExpensesAmt |
| CY Other Expenses | $7,218,970 | CYOtherExpensesAmt |
| PY Total Expenses | $23,946,447 | PYTotalExpensesAmt |
| CY Total Expenses | $25,680,694 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,582,179 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$272,829 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $23,789,189 | TotalAssetsBOYAmt |
| Total Assets EOY | $22,936,073 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,335,048 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,727,449 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $20,454,141 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $20,208,624 | NetAssetsOrFundBalancesEOYAmt |
| Mission | EISNER PEDIATRIC & FAMILY MEDICAL CENTER IS A QUALITY-FOCUSED, COMMUNITY HEALTH CENTER DEDICATED TO IMPROVING THE PHYSICAL, SOCIAL AND EMOTIONAL WELL-BEING OF LOW AND MODERATE INCOME RESIDENTS OF DOWNTOWN AND CENTRAL LOS ANGELES, REGARDLESS OF THEIR ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $15,764,144 | ExpenseAmt |
| Revenue | $16,409,557 | RevenueAmt |
| Desc | MEDICAL CARE- PHYSICAL EXAMS - IMMUNIZATIONS - GYNECOLOGY SERVICES - COUNSELING - PREVENTATIVE MEDICINE- DIAGNOSIS AND MANAGEMENT OF ACUTE AND CHRONIC DISEASES- DIAGNOSIS AND CARE DURING PREGNANCY- OFFICE DERMATOLOGYTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 28,931. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,271,355 | ExpenseAmt |
| Revenue | $3,029,103 | RevenueAmt |
| Desc | DENTAL CARE- PREVENTATIVE DENTAL EXAMS- DIAGNOSIS AND TREATMENT OF DENTAL AND GUM PROBLEMS- ORTHODONTIC SERVICESTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 6,948. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,388,918 | ExpenseAmt |
| Revenue | $1,113,338 | RevenueAmt |
| Desc | MENTAL HEALTH CARE- INDIVIDUAL THERAPY - FAMILY THERAPY - GROUP THERAPY - CASE MANAGEMENT - WORKSHOPS - PARENTING CLASSESTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 368. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $21,424,417 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 38 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 347 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EUGENE VEKSLER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2137461037 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1530 SOUTH OLIVE ST | AddressLine1 |
| City | LOS ANGELES | City |
| State | CA | State |
| ZIP Code | 90015 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| VICTOR AGUIRRE | |||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| DAVID BENAVIDEZ | |||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JERRY GATES | |||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| NORMA IBARRA | |||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| LOREN J KOSMONT | |||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| KEVIN KROEKER | |||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| ALEJANDRA ROSAS | |||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MARGARET PETERSON | |||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| KEVIN ROSSI | |||||||||
| CHAIRPERSON | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| EDWARD MATTHEWS | |||||||||
| VICE CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| IRMA AVILA | |||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| IAN WIENER | |||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| CARL E COAN | |||||||||
| PRESIDENT/CEO | 40.00 | $271,423 | $0 | $40,449 | Yes (X) | 5.00 | |||
| CHONA DE LOAN | |||||||||
| VICE PRESIDENT/COO | 40.00 | $251,122 | $0 | $12,626 | Yes (X) | ||||
| LAILA AL-MARAYATI | |||||||||
| DIRECT OF OB SERVICES | 40.00 | $211,560 | $0 | $11,825 | Yes (X) | ||||
| LUIS LOPEZ | |||||||||
| DIRECTOR OF PEDIATRICS | 40.00 | $207,174 | $0 | $11,342 | Yes (X) | ||||
| LAWRENCE YEE | |||||||||
| DIRECTOR OF ADULT SERVICES | 40.00 | $197,510 | $0 | $11,370 | Yes (X) | ||||
| JOHN PHAM | |||||||||
| DIRECTOR OF DENTAL | 40.00 | $152,396 | $0 | $9,652 | Yes (X) | ||||
| DEBORAH LERNER | |||||||||
| CHIEF MEDICAL OFFICER | 40.00 | $207,331 | $0 | $11,349 | Yes (X) | ||||
| HIRAM WILLIAMS | |||||||||
| PHYSICIAN | 40.00 | $199,316 | $0 | $11,142 | Yes (X) | ||||
| PENELOPE VELASCO | |||||||||
| PHYSICIAN | 40.00 | $180,776 | $0 | $10,810 | Yes (X) | ||||
| AHMAD KHALIFA | |||||||||
| PHYSICIAN | 40.00 | $195,776 | $0 | $10,958 | Yes (X) | ||||
| IAN TILLEY | |||||||||
| PHYSICIAN | 40.00 | $170,859 | $0 | $10,206 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,245,243 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $151,729 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 35 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| QUEST DIAGNOSTICS | |||||
| 8511 FALLBROOK AVENUE 2ND FL | WEST HILLS | CA | 91304 | LABORATORY EXPENSES | $314,431 |
| ELLIS BEESLEY MD | |||||
| 1127 WILSHIRE BLVD 707 | LOS ANGELES | CA | 90017 | NEW-BORN EXAMS | $118,087 |
| DAVIS WRIGHT TREMAINE LLP | |||||
| 1201 3RD AVENUE STE 2200 | SEATTLE | WA | 98101 | LEGAL SERVICES | $105,987 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $124,252 | RelatedOrganizationsAmt |
| Government Grants | $3,281,215 | GovernmentGrantsAmt |
| All Other Contributions | $1,440,327 | AllOtherContributionsAmt |
| Total Contributions | $4,845,794 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE FEES | Desc |
| Business | 624110 | BusinessCd |
| Total Revenue Column | $20,551,998 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,551,998 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $20,551,998 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,137 | TotalRevenueColumnAmt |
| Exclusion | $1,137 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $8,936 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $8,936 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,936 | TotalRevenueColumnAmt |
| Exclusion | $8,936 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,407,865 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,551,998 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $10,073 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,422,393 | TotalAmt |
| Program Services | $1,197,618 | ProgramServicesAmt |
| Management And General | $213,361 | ManagementAndGeneralAmt |
| Fundraising | $11,414 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,587,852 | TotalAmt |
| Program Services | $11,486,137 | ProgramServicesAmt |
| Management And General | $1,998,811 | ManagementAndGeneralAmt |
| Fundraising | $102,904 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $347,694 | TotalAmt |
| Program Services | $269,008 | ProgramServicesAmt |
| Management And General | $72,694 | ManagementAndGeneralAmt |
| Fundraising | $5,992 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,951,952 | TotalAmt |
| Program Services | $1,650,032 | ProgramServicesAmt |
| Management And General | $287,138 | ManagementAndGeneralAmt |
| Fundraising | $14,782 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,151,833 | TotalAmt |
| Program Services | $972,533 | ProgramServicesAmt |
| Management And General | $168,838 | ManagementAndGeneralAmt |
| Fundraising | $10,462 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,418 | TotalAmt |
| Management And General | $37,418 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,921 | TotalAmt |
| Management And General | $62,921 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,746,770 | TotalAmt |
| Program Services | $1,584,316 | ProgramServicesAmt |
| Management And General | $131,239 | ManagementAndGeneralAmt |
| Fundraising | $31,215 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,277 | TotalAmt |
| Program Services | $10,007 | ProgramServicesAmt |
| Management And General | $11,790 | ManagementAndGeneralAmt |
| Fundraising | $480 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $263,033 | TotalAmt |
| Program Services | $173,618 | ProgramServicesAmt |
| Management And General | $83,485 | ManagementAndGeneralAmt |
| Fundraising | $5,930 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $162,397 | TotalAmt |
| Program Services | $118,154 | ProgramServicesAmt |
| Management And General | $43,617 | ManagementAndGeneralAmt |
| Fundraising | $626 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $589,191 | TotalAmt |
| Program Services | $508,261 | ProgramServicesAmt |
| Management And General | $80,930 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $294,597 | TotalAmt |
| Program Services | $253,265 | ProgramServicesAmt |
| Management And General | $39,391 | ManagementAndGeneralAmt |
| Fundraising | $1,941 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,508 | TotalAmt |
| Program Services | $27,649 | ProgramServicesAmt |
| Management And General | $13,641 | ManagementAndGeneralAmt |
| Fundraising | $218 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,223 | TotalAmt |
| Program Services | $9,554 | ProgramServicesAmt |
| Management And General | $21,669 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,204,920 | TotalAmt |
| Program Services | $1,204,920 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $206,996 | TotalAmt |
| Program Services | $159,611 | ProgramServicesAmt |
| Management And General | $47,385 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $1,463,149 | $1,463,149 | ||
| CLINIC MAINTENANCE | $141,790 | $52,091 | $89,699 | |
| BUILDING MAINTENANCE | $118,940 | $31,007 | $87,933 | |
| SUBSCRIPTIONS | $76,332 | $28,271 | $44,823 | $3,238 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $755,508 | TotalAmt |
| Program Services | $225,216 | ProgramServicesAmt |
| Management And General | $507,863 | ManagementAndGeneralAmt |
| Fundraising | $22,429 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,680,694 | TotalAmt |
| Program Services | $21,424,417 | ProgramServicesAmt |
| Management And General | $4,044,646 | ManagementAndGeneralAmt |
| Fundraising | $211,631 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $303,471 | BOYAmt |
| EOY | $274,881 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $779,954 | BOYAmt |
| EOY | $850,095 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,396,456 | BOYAmt |
| EOY | $1,378,467 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,382,755 | BOYAmt |
| EOY | $5,176,758 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $206,931 | BOYAmt |
| EOY | $344,864 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $23,883,285 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,087,773 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,583,384 | BOYAmt |
| EOY | $14,795,512 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,667 | BOYAmt |
| EOY | $57,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,571 | BOYAmt |
| EOY | $58,496 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,789,189 | BOYAmt |
| EOY | $22,936,073 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,592,099 | BOYAmt |
| EOY | $2,402,834 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $742,949 | BOYAmt |
| EOY | $324,615 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,335,048 | BOYAmt |
| EOY | $2,727,449 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,662,845 | BOYAmt |
| EOY | $19,693,130 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $791,296 | BOYAmt |
| EOY | $515,494 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,454,141 | BOYAmt |
| EOY | $20,208,624 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,789,189 | BOYAmt |
| EOY | $22,936,073 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$272,829 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $27,312 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $952,246 | OtherCostOrOtherBasisAmt |
| Book Value | $952,246 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,461,781 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,491,094 | DepreciationAmt |
| Book Value | $11,970,687 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,867,726 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,215,082 | DepreciationAmt |
| Book Value | $1,652,644 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $601,532 | OtherCostOrOtherBasisAmt |
| Depreciation | $381,597 | DepreciationAmt |
| Book Value | $219,935 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $14,795,512 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $25,407,865 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $25,407,865 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $25,407,865 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $25,653,382 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$27,312 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$27,312 | ExpensesNotReportedAmt |
| Expenses Subtotal | $25,680,694 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $25,680,694 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART XII, LINE 2D - OTHER ADJUSTMENTS: | FormAndLineReferenceDesc |
| Explanation | BAD DEBT RECOVERY -27,312. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CARL E COAN | ||||||||||||||
| PRESIDENT/CEO | $246,423 | $0 | $25,000 | $0 | $0 | $0 | $35,369 | $0 | $5,080 | $0 | $311,872 | $0 | $0 | $0 |
| CHONA DE LOAN | ||||||||||||||
| VICE PRESIDENT/COO | $226,122 | $0 | $25,000 | $0 | $0 | $0 | $7,546 | $0 | $5,080 | $0 | $263,748 | $0 | $0 | $0 |
| LAILA AL-MARAYATI | ||||||||||||||
| DIRECT OF OB SERVICES | $208,685 | $0 | $2,875 | $0 | $0 | $0 | $6,745 | $0 | $5,080 | $0 | $223,385 | $0 | $0 | $0 |
| LUIS LOPEZ | ||||||||||||||
| DIRECTOR OF PEDIATRICS | $204,674 | $0 | $2,500 | $0 | $0 | $0 | $6,262 | $0 | $5,080 | $0 | $218,516 | $0 | $0 | $0 |
| LAWRENCE YEE | ||||||||||||||
| DIRECTOR OF ADULT SERVICES | $197,510 | $0 | $0 | $0 | $0 | $0 | $6,290 | $0 | $5,080 | $0 | $208,880 | $0 | $0 | $0 |
| JOHN PHAM | ||||||||||||||
| DIRECTOR OF DENTAL | $152,396 | $0 | $0 | $0 | $0 | $0 | $4,572 | $0 | $5,080 | $0 | $162,048 | $0 | $0 | $0 |
| DEBORAH LERNER | ||||||||||||||
| CHIEF MEDICAL OFFICER | $197,581 | $0 | $9,750 | $0 | $0 | $0 | $6,269 | $0 | $5,080 | $0 | $218,680 | $0 | $0 | $0 |
| HIRAM WILLIAMS | ||||||||||||||
| PHYSICIAN | $197,066 | $0 | $2,250 | $0 | $0 | $0 | $6,062 | $0 | $5,080 | $0 | $210,458 | $0 | $0 | $0 |
| PENELOPE VELASCO | ||||||||||||||
| PHYSICIAN | $178,901 | $0 | $1,875 | $0 | $0 | $0 | $5,730 | $0 | $5,080 | $0 | $191,586 | $0 | $0 | $0 |
| AHMAD KHALIFA | ||||||||||||||
| PHYSICIAN | $171,526 | $0 | $24,250 | $0 | $0 | $0 | $5,878 | $0 | $5,080 | $0 | $206,734 | $0 | $0 | $0 |
| IAN TILLEY | ||||||||||||||
| PHYSICIAN | $165,109 | $0 | $5,750 | $0 | $0 | $0 | $5,126 | $0 | $5,080 | $0 | $181,065 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | STAFF BONUSES ARE DISCUSSED AND REQUIRE APPROVAL BY SENIOR MANAGEMENT. THERE ARE SEVERAL CRITERIA FOR ADMINISTERING BONUSES. SENIOR MANAGEMENT MAY GET A BONUS BASED ON THE DEGREE OF MEETING THEIR SET GOALS FOR THE PAST FISCAL YEAR. OTHER STAFF, WHO ARE AT THE TOP OF THEIR JOB'S SALARY RANGE, MAY BE GIVEN A BONUS BASED ON THEIR PERFORMANCE RATING. THE PERCENTAGE OF THE BONUS CAN BE UP TO AND EQUIVALENT TO A 3% RAISE. HOWEVER, THERE MAY BE EXCEPTIONS WHERE THE BONUS IS MORE THAN 3%. OTHER STAFF, WHO HAVE DEMONSTRATED A PERFORMANCE OVER AND BEYOND HIS OR HER JOB EXPECTATIONS MAY GET A BONUS IN ADDITION TO THE RAISE IF THE SUPERVISOR FEELS THAT THE STAFF DESERVES MORE THAN THE 3% RAISE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS GIVEN TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUAL QUESTIONNAIRES ARE GIVEN TO ALL DIRECTORS AND OFFICERS. THE GOVERNANCE COMMITTEE THEN REVIEWS THE QUESTIONNAIRES TO ENSURE THE COMPLIANCE OF THE CONFLICT OF INTEREST POLICY. IF A CONFLICT ARISES IT IS RESOLVED THROUGH BOARD DISCUSSION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE GOVERNANCE COMMITTEE USES AN INDEPENDENT CONSULTANT AND A COMPENSATION SURVEY STUDY IN ORDER TO DETERMINE THE COMPENSATION FOR THE CEO, OFFICERS, AND KEY EMPLOYEES. ONCE THE COMPENSATION IS DETERMINED THEN IT IS PRESENTED TO THE ENTIRE BOARD FOR APPROVAL. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | BAD DEBT RECOVERY 27,312. |
| FORM 990, PART XII, LINE 2C | NO CHANGES WERE MADE TO THE FINANCIAL STATEMENT REPORTING PROCESS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEDIATRIC & FAMILY MEDICAL FOUNDATION | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1530 S OLIVE ST | AddressLine1 |
| City | LOS ANGELES | City |
| State | CA | State |
| ZIP Code | 90015 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 954116680 | EIN |
| Primary Activities | TO HOLD AND INVEST ASSETS ON BEHALF OF PEDIATRIC & FAMILY MEDICAL CENTER | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 509(A)(3) TYPE I | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEDIATRIC & FAMILY MEDICAL FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $124,252 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |