Active NPI
St. Johns Urgent Care & Medical Corporation
- General Practice Physician
- Los Angeles, CA
National Provider Identifier
1023524980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- A50108
- Legal business name
- ST. JOHNS URGENT CARE & MEDICAL CORPORATION
- Practice address
- 1138 N Western Ave
Los Angeles, CA 90029-1702 - Phone
- (323) 957-9300
- Fax
- (323) 957-9315
- NPI assigned
- Dec 14, 2017
- Organization subpart
- Yes
- Parent organization
- ST .JOHN URGENT CARE & MEDICAL CORPORATION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mike Mansour Rostami, M.D
- Title
- Medical Director/ Owner
- Phone
- (323) 957-9300
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | A50108 | CA | Primary |
Addresses
Primary practice location
1138 N Western Ave
Los Angeles, CA 90029-1702
Mailing address
1138 North Western Ave
Los Angeles, CA 90029-1702
Phone (323) 957-9300
Other names 1
- none
National Provider Directory
National Provider Directory- Part of
- St Johns Urgent Care Medic
Locations
1138 N Western Ave
Los Angeles, CA 90029
Phone (323) 957-9300
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Physician
- Los Angeles, CA
- NPI 1720135726
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513209600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1513728000000",
"number": "1023524980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1138 NORTH WESTERN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900291702",
"telephone_number": "323-957-9300",
"fax_number": "323-957-9315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1138 N WESTERN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900291702",
"telephone_number": "323-957-9300",
"fax_number": "323-957-9315"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST. JOHNS URGENT CARE & MEDICAL CORPORATION",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ST .JOHN URGENT CARE & MEDICAL CORPORATION",
"enumeration_date": "2017-12-14",
"last_updated": "2017-12-20",
"status": "A",
"authorized_official_last_name": "ROSTAMI",
"authorized_official_first_name": "MIKE",
"authorized_official_middle_name": "MANSOUR",
"authorized_official_title_or_position": "MEDICAL DIRECTOR/ OWNER",
"authorized_official_telephone_number": "323-957-9300",
"authorized_official_credential": "M.D"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": "CA",
"license": "A50108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "none",
"code": "4",
"type": "Former Legal Business Name"
}
]
}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 Dec 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.