NPIMap

Organization Active NPI

Cor Medical Group, Inc

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1023223229
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G066869 Issued in CA
Legal business name
COR MEDICAL GROUP, INC
Practice address
8635 W 3Rd St
Suite 890W
Los Angeles, CA 90048-6101
Phone
(310) 659-0714
Fax
(310) 659-0664
NPI assigned
May 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mark Kenneth Urman, MDNPI 1497827448
Title
VP
Phone
(310) 659-0714

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X G066869 CA Primary

Addresses

Primary practice location

8635 W 3Rd St
Suite 890W
Los Angeles, CA 90048-6101

Mailing address

8635 W 3Rd St
Suite 890W
Los Angeles, CA 90048-6101
Phone (310) 659-0714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050418000508 CA Part B Supplier - Clinic/Group Practice 2567400989 Receives reassigned benefits from 3 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

8635 W 3rd St
Ste 890W
Los Angeles, CA 90048
Phone (310) 659-0714

8635 W 3rd St
Ste 890
West Hollywood, CA 90048
Phone (213) 422-3843

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023223229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST",
            "address_2": "SUITE 890W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486101",
            "telephone_number": "310-659-0714",
            "fax_number": "310-659-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST",
            "address_2": "SUITE 890W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486101",
            "telephone_number": "310-659-0714",
            "fax_number": "310-659-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COR MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "URMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "310-659-0714",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G066869",
            "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.