PEDIATRIC AND FAMILY MEDICAL CENTER: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- PEDIATRIC AND FAMILY MEDICAL CENTER (EIN 95-1690966)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-02-12
- IRS object ID
- 201410439349301736
- Schema version
- 2012v2.1
- 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) |
|---|---|---|
| Timestamp | 2014-02-12T15:41:36-06:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 951777440 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREEN HASSON & JANKS LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| 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 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 951690966 | EIN |
Name Name
| 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) |
|---|---|---|
| Name Control | PEDI | NameControl |
| Phone | 2137461037 | Phone |
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 |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CARL E COAN | Name |
| Title | PRESIDENT/CEO | Title |
| Phone | 2137461037 | Phone |
| Date Signed | 2014-01-29 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RICHARD L RUVELSON | Name |
| PTIN | P00234075 | PTIN |
| Phone | 3108731600 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EISNER PEDIATRICS & FAMILY MED CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CARL E COAN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| 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 | 27528626 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.PEDCENTER.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1920 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | IMPROVE THE PHYSICAL, SOCIAL & EMOTIONAL WELL-BEING OF LOS ANGELES FAMILIES | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 314 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 5944814 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 7837509 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 18458789 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 19676168 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2784 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1695 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 133520 | OtherRevenuePriorYear |
| Other Revenue Current Year | 13254 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 24539907 | TotalRevenuePriorYear |
| Total Revenue Current Year | 27528626 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 16066235 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 16955943 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 406341 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 6239152 | OtherExpensePriorYear |
| Other Expenses Current Year | 6990504 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 22305387 | TotalExpensesPriorYear |
| Total Expenses Current Year | 23946447 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2234520 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3582179 | RevenuesLessExpensesCY |
| Total Assets BOY | 20508832 | TotalAssetsBOY |
| Total Assets EOY | 23789189 | TotalAssetsEOY |
| Total Liabilities BOY | 3442212 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3335048 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 17066620 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 20454141 | NetAssetsOrFundBalancesEOY |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 14916067 | Expense |
| Revenue | 16234368 | Revenue |
| Description | 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 26,992. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2808986 | Expense |
| Revenue | 2300663 | Revenue |
| Description | DENTAL CARE- PREVENTATIVE DENTAL EXAMS- DIAGNOSIS AND TREATMENT OF DENTAL AND GUM PROBLEMS- ORTHODONTIC SERVICESTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 7,183. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2124416 | Expense |
| Revenue | 1141137 | Revenue |
| Description | MENTAL HEALTH CARE- INDIVIDUAL THERAPY - FAMILY THERAPY - GROUP THERAPY - CASE MANAGEMENT - WORKSHOPS - PARENTING CLASSESTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 277. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 19849469 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 33 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 314 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EUGENE VEKSLER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2137461037 | TelephoneNumber |
Address US AddressUS
| 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 Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| VICTOR AGUIRRE | ||||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| DAVID BENAVIDEZ | ||||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| JERRY GATES | ||||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| NORMA IBARRA | ||||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| LOREN J KOSMONT | ||||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| KEVIN KROEKER | ||||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| CRAIG MYERS | ||||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| ALEJANDRA ROSAS | ||||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| KEVIN ROSSI | ||||||||
| CHAIRPERSON | 1.00 | X | 0 | 0 | 0 | X | ||
| EDWARD MATTHEWS | ||||||||
| VICE CHAIR | 1.00 | X | 0 | 0 | 0 | X | ||
| IRMA AVILA | ||||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | X | ||
| JEFFREY WANG | ||||||||
| TRESURER | 1.00 | X | 0 | 0 | 0 | X | ||
| CARL E COAN | ||||||||
| PRESIDENT/CEO | 40.00 | 261030 | 0 | 39669 | X | |||
| CHONA DE LEON | ||||||||
| VICE PRESIDENT/COO | 40.00 | 244535 | 0 | 12434 | X | |||
| LAWRENCE YEE | ||||||||
| DIRECTOR OF ADULT SERVICES | 40.00 | 205243 | 0 | 11637 | X | |||
| LUIS LOPEZ | ||||||||
| DIRECTOR OF PEDIATRICS | 40.00 | 204700 | 0 | 11250 | X | |||
| LAILA AL-MARAYATI | ||||||||
| DIRECTOR OF OB SERVICES | 40.00 | 201408 | 0 | 11589 | X | |||
| JOHN PHAM | ||||||||
| DIRECTOR OF DENTAL | 40.00 | 150398 | 0 | 9598 | X | |||
| DEBORAH LERNER | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | 201673 | 0 | 11164 | X | |||
| AHMAD KHALIFA | ||||||||
| PHYSICIAN | 40.00 | 199855 | 0 | 11087 | X | |||
| DAVID ENGEL | ||||||||
| PHYSICIAN | 40.00 | 165245 | 0 | 10095 | X | |||
| HIREN PATEL | ||||||||
| PHYSICIAN | 36.00 | 162526 | 0 | 9962 | X | |||
| IAN TILLEY | ||||||||
| PHYSICIAN | 32.00 | 158050 | 0 | 9827 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2154663 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 148312 | TotalOtherCompensation |
| Number Individuals GT100 K | 31 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | QUEST DIAGNOSTICS | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8511 FALLBROOK AVENUE 2ND FL | AddressLine1 |
| City | WEST HILLS | City |
| State | CA | State |
| ZIP Code | 91304 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | LABORATORY EXPENSES | DescriptionOfServices |
| Compensation | 266042 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Related Organizations | 390000 | RelatedOrganizations |
| Government Grants | 6469455 | GovernmentGrants |
| All Other Contributions | 978054 | AllOtherContributions |
| Noncash Contributions | 62742 | NoncashContributions |
| Total Contributions | 7837509 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE FEES | Description |
| Business Code | 624110 | BusinessCode |
| Total Revenue Column | 19676168 | TotalRevenueColumn |
| Related Or Exempt Function Income | 19676168 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 19676168 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1695 | TotalRevenueColumn |
| Exclusion | $1,695 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 13254 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 13254 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 13254 | TotalRevenueColumn |
| Exclusion | $13,254 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 27528626 | TotalRevenueColumn |
| Related Or Exempt Function Income | 19676168 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $14,949 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1393628 | Total |
| Program Services | 1164252 | ProgramServices |
| Management And General | 204863 | ManagementAndGeneral |
| Fundraising | 24513 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12255601 | Total |
| Program Services | 10280423 | ProgramServices |
| Management And General | 1787950 | ManagementAndGeneral |
| Fundraising | 187228 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 320530 | Total |
| Program Services | 245600 | ProgramServices |
| Management And General | 54315 | ManagementAndGeneral |
| Fundraising | 20615 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1900629 | Total |
| Program Services | 1594314 | ProgramServices |
| Management And General | 277280 | ManagementAndGeneral |
| Fundraising | 29035 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1085555 | Total |
| Program Services | 907213 | ProgramServices |
| Management And General | 158049 | ManagementAndGeneral |
| Fundraising | 20293 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 102745 | Total |
| Management And General | 102745 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 60948 | Total |
| Management And General | 60948 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1777614 | Total |
| Program Services | 1692863 | ProgramServices |
| Management And General | 21574 | ManagementAndGeneral |
| Fundraising | 63177 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50380 | Total |
| Program Services | 18750 | ProgramServices |
| Management And General | 16085 | ManagementAndGeneral |
| Fundraising | 15545 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 261436 | Total |
| Program Services | 167654 | ProgramServices |
| Management And General | 86055 | ManagementAndGeneral |
| Fundraising | 7727 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 242704 | Total |
| Program Services | 185617 | ProgramServices |
| Management And General | 52635 | ManagementAndGeneral |
| Fundraising | 4452 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 602923 | Total |
| Program Services | 538093 | ProgramServices |
| Management And General | 64830 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 310224 | Total |
| Program Services | 273058 | ProgramServices |
| Management And General | 35053 | ManagementAndGeneral |
| Fundraising | 2113 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45897 | Total |
| Program Services | 29493 | ProgramServices |
| Management And General | 15018 | ManagementAndGeneral |
| Fundraising | 1386 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44416 | Total |
| Program Services | 6605 | ProgramServices |
| Management And General | 37811 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1072278 | Total |
| Program Services | 1072278 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 221633 | Total |
| Program Services | 175668 | ProgramServices |
| Management And General | 45965 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| MEDICAL SUPPLIES | 1200028 | 1200028 | ||
| CLINIC MAINTENANCE | 135272 | 45686 | 89586 | |
| SUBSCRIPTIONS | 100184 | 23851 | 63484 | 12849 |
| BUILDING MAINTENANCE | 96413 | 19200 | 77213 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 665409 | Total |
| Program Services | 208823 | ProgramServices |
| Management And General | 439178 | ManagementAndGeneral |
| Fundraising | 17408 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23946447 | Total |
| Program Services | 19849469 | ProgramServices |
| Management And General | 3690637 | ManagementAndGeneral |
| Fundraising | 406341 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30058 | BOY |
| EOY | 303471 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1268627 | BOY |
| EOY | 779954 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1206660 | BOY |
| EOY | 1396456 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4373286 | BOY |
| EOY | 5382755 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 190087 | BOY |
| EOY | 206931 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 23472902 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7889518 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13298884 | BOY |
| EOY | 15583384 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 68667 | BOY |
| EOY | 63667 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 72563 | BOY |
| EOY | 72571 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20508832 | BOY |
| EOY | 23789189 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2296894 | BOY |
| EOY | 2592099 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1145318 | BOY |
| EOY | 742949 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3442212 | BOY |
| EOY | 3335048 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16499752 | BOY |
| EOY | 19662845 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 566868 | BOY |
| EOY | 791296 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17066620 | BOY |
| EOY | 20454141 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20508832 | BOY |
| EOY | 23789189 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 3582179 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -194658 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 952246 | OtherCostOrOtherBasis |
| Book Value | 952246 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 17461781 | OtherCostOrOtherBasis |
| Depreciation | 4937660 | Depreciation |
| Book Value | 12524121 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4527562 | OtherCostOrOtherBasis |
| Depreciation | 2601386 | Depreciation |
| Book Value | 1926176 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 531313 | OtherCostOrOtherBasis |
| Depreciation | 350472 | Depreciation |
| Book Value | 180841 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 15583384 | TotalOfBookValueLandBuildings |
| Tot Revenue Etc Audited Fincl Stmt | 27528626 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 27528626 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 27528626 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 24141105 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 194658 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 194658 | ExpensesNotRptdF990 |
| Expenses Subtotal | 23946447 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 23946447 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART XII, LINE 2D - OTHER ADJUSTMENTS: | Identifier |
| Explanation | BAD DEBT 194,658. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CARL E COAN | ||||||||||||||
| PRESIDENT/CEO | 240197 | 0 | 20833 | 0 | 0 | 0 | 34583 | 0 | 5086 | 0 | 300699 | 0 | 0 | 0 |
| CHONA DE LEON | ||||||||||||||
| VICE PRESIDENT/COO | 221535 | 0 | 23000 | 0 | 0 | 0 | 7348 | 0 | 5086 | 0 | 256969 | 0 | 0 | 0 |
| LAWRENCE YEE | ||||||||||||||
| DIRECTOR OF ADULT SERVICES | 205243 | 0 | 0 | 0 | 0 | 0 | 6551 | 0 | 5086 | 0 | 216880 | 0 | 0 | 0 |
| LUIS LOPEZ | ||||||||||||||
| DIRECTOR OF PEDIATRICS | 201700 | 0 | 3000 | 0 | 0 | 0 | 6164 | 0 | 5086 | 0 | 215950 | 0 | 0 | 0 |
| LAILA AL-MARAYATI | ||||||||||||||
| DIRECTOR OF OB SERVICES | 199283 | 0 | 2125 | 0 | 0 | 0 | 6503 | 0 | 5086 | 0 | 212997 | 0 | 0 | 0 |
| JOHN PHAM | ||||||||||||||
| DIRECTOR OF DENTAL | 150398 | 0 | 0 | 0 | 0 | 0 | 4512 | 0 | 5086 | 0 | 159996 | 0 | 0 | 0 |
| DEBORAH LERNER | ||||||||||||||
| CHIEF MEDICAL OFFICER | 191813 | 0 | 9860 | 0 | 0 | 0 | 6078 | 0 | 5086 | 0 | 212837 | 0 | 0 | 0 |
| AHMAD KHALIFA | ||||||||||||||
| PHYSICIAN | 187855 | 0 | 12000 | 0 | 0 | 0 | 6001 | 0 | 5086 | 0 | 210942 | 0 | 0 | 0 |
| DAVID ENGEL | ||||||||||||||
| PHYSICIAN | 148745 | 0 | 16500 | 0 | 0 | 0 | 5009 | 0 | 5086 | 0 | 175340 | 0 | 0 | 0 |
| HIREN PATEL | ||||||||||||||
| PHYSICIAN | 157151 | 0 | 5375 | 0 | 0 | 0 | 4876 | 0 | 5086 | 0 | 172488 | 0 | 0 | 0 |
| IAN TILLEY | ||||||||||||||
| PHYSICIAN | 156675 | 0 | 1375 | 0 | 0 | 0 | 4741 | 0 | 5086 | 0 | 167877 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 7 | ReturnReference |
| 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. | Explanation |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | EQUIPMENT | Description |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 62742 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Form990 Schedule M Part II Form990ScheduleMPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | METHOD FOR DETERMINING NUMBER OF CONTRIBUTIONS: | Identifier |
| Return Reference | PART I, COLUMN (B): | ReturnReference |
| Explanation | NON CASH CONTRIBUTIONS ARE LISTED BY TOTAL NUMBER OF DONORS. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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 -194,658. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C | NO CHANGES WERE MADE TO THE FINANCIAL STATEMENT REPORTING PROCESS. | FINANCIAL STATEMENTS AND REPORTING |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEDIATRIC & FAMILY MEDICAL FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| 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 | PrimaryActivities |
| Legal Domicile State | CA | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 509(A)(3) TYPE I | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEDIATRIC & FAMILY MEDICAL FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionType |
| Amount Involved | 390000 | AmountInvolved |
| Method Of Amt Determination | FMV | MethodOfAmtDetermination |
Comments