Southern California Permanente Medical Group
Organization Active NPI Health Maintenance Organization · Bellflower, CA
NPI 1043242555 · NPPES record last updated Nov 2, 2021
Key facts
- NPI
- 1043242555
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health Maintenance Organization 302R00000X
- Legal business name
- SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
- Practice address
- 9400 Rosecrans Ave
Bellflower, CA 90706-2246 - Phone
- (562) 461-3000
- NPI assigned
- Jul 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Ramin Davidoff, M.D.
- Title
- Executive Medical Director
- Phone
- (877) 608-0044
Other NPIs on the same Medicare enrollment 24
Practitioners 775
-
Afshan Roohi Abbasi, M.D.
-
Beza Abebe, MD
-
Muhammad Omar Abou-Harb, HEALTH CARE 39020000
-
Maria A Abrantes, MD
-
Nichole Marie Adair, D.O.
-
Olufemi Michael Adenuga, M.D, MPH
-
Nina Agarwal, D.O.
-
Genoveva Aguilar, M.D.
-
Dean Ahn, MD
-
Ryan Alano, MD, MPH
-
Claudia Alas, M.D.
-
Baber H. Ali, MD
-
Carmen E Aliyeva, AU.D
-
Susan Ung Almazan, O.D.
-
Sowmya Ananthanarayanan, M.D.
-
Michelle Darlene Andersen, D.P.T.
-
Dristi Angdembey, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031110000678 | CA | Part B Supplier - Clinic/Group Practice | 6002729175 |
Receives reassigned benefits from 14,591 practitioners 21 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
| O20260217001864 | CA | MDPP Supplier - in-Person MDPP Supplier With Distance Learning | 6002729175 |
12 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
10820 183rd St
Cerritos, CA 90703
Phone (562) 653-5000
9449 Imperial Hwy
Downey, CA 90242
Phone (562) 657-2604
1601 Kingsdale Ave
Redondo Beach, CA 90278
Phone (310) 750-0003
12470 Whittier Blvd
Whittier, CA 90602
Phone (562) 907-3509
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Maintenance Organization | 302R00000X | Yes |
Addresses
Primary practice location
9400 Rosecrans Ave
Bellflower, CA 90706-2246
Mailing address
393 E Walnut St
3Rd FL PHR Group & Provider Enrollment
Pasadena, CA 91188-0001
Phone (626) 405-7914
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ38880Z | Medicaid | CA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) |
Other providers in Bellflower, CA
- Bernardo Sosa Jr.
- Frank Clifford Soto
- South Pacific
- Southern California Alcohol & Drug Programs, Inc.
- Southern California Health & Rehabilitation Program
- Caroline Chen Spagnola
- Tiffany Spearman
- Spectrum Solutions Therapy Inc
- Deborah Spolter
- Jennifer Bassell Sprawls
All providers in Bellflower, CA · Health Maintenance Organization in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.