Jimmy L Ezell Medical Corp

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

C27187 Issued in CA

Legal business name

JIMMY L EZELL MEDICAL CORP

Practice address

7500 S Western Ave
Los Angeles, CA 90047-2429

Phone

(323) 971-2250

Fax

(323) 971-5605

NPI assigned

Feb 20, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Jimmy L Ezell, M.D

Title

President

Phone

(323) 971-2250

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1235088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236297600000",
    "number": "1053551739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900472429",
            "telephone_number": "323-971-2250",
            "fax_number": "323-971-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900472429",
            "telephone_number": "323-971-2250",
            "fax_number": "323-971-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIMMY L EZELL MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-20",
        "last_updated": "2009-03-06",
        "status": "A",
        "authorized_official_last_name": "EZELL",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-971-2250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "C27187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C271870",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendy I Jimenez
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• Desiree Jimmy, RN
• Lilly Jimoh
• Jin Acupuncture a Professional Corporation

• Primary Care Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; 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.