NPIMap

Organization Active NPI

Los Angeles Clinica Medica General Medical Center, Inc.

  • Family Medicine Physician
  • Huntington Park, CA
National Provider Identifier
1003469214
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LOS ANGELES CLINICA MEDICA GENERAL MEDICAL CENTER, INC.
Practice address
7400 Pacific Blvd Ste Ab
Huntington Park, CA 90255-5954
Phone
(323) 583-8383
Fax
(323) 583-8399
NPI assigned
Jul 17, 2019
Last updated
Jul 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jose L Carrillo
Title
Office Manager
Phone
(213) 739-3282

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

7400 Pacific Blvd Ste Ab
Huntington Park, CA 90255-5954

Mailing address

2208 W 7TH St
Los Angeles, CA 90057-4002
Phone (213) 384-3434

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL jlcarrillo@lacmg.com Direct
Direct Messaging Address jlcarrillo@lacmg.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Los Angeles Clinica Medica General Medical Center Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7400 Pacific Blvd
Ste Ab
Walnut Park, CA 90255
Phone (323) 538-9050

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689724800000",
    "number": "1003469214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 W 7TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900574002",
            "telephone_number": "213-384-3434",
            "fax_number": "213-386-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 PACIFIC BLVD STE AB",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902555954",
            "telephone_number": "323-583-8383",
            "fax_number": "323-583-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES CLINICA MEDICA GENERAL MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-17",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "213-739-3282"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jlcarrillo@lacmg.com",
            "affiliation": "N",
            "endpointDescription": "jlcarrillo@lacmg.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6347 Pacific Blvd",
            "city": "Huntington Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902554101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlcarrillo@lacmg.com",
            "affiliation": "N",
            "endpointDescription": "jlcarrillo@lacmg.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6347 Pacific Blvd",
            "city": "Huntington Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902554101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.