Organization Active NPI

Fatima Medical Center

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1013362177
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FATIMA MEDICAL CENTER
Practice address
3700 Wilshire Blvd
422
Los Angeles, CA 90010-2901
Phone
(213) 677-9276
NPI assigned
Apr 26, 2016
Last updated
Apr 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Authorized official

Name
Jacob Edem
Title
Administrator
Phone
(213) 718-6670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

3700 Wilshire Blvd
422
Los Angeles, CA 90010-2901

Mailing address

3700 Wilshire Blvd
422
Los Angeles, CA 90010-2901

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461628800000",
    "number": "1013362177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 WILSHIRE BLVD",
            "address_2": "422",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WILSHIRE BLVD",
            "address_2": "422",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102901",
            "telephone_number": "213-677-9276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FATIMA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-04-26",
        "status": "A",
        "authorized_official_last_name": "EDEM",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "213-718-6670"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; 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.