Organization Active NPI

Lincoln Heights Urgent Care

  • Urgent Care Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1053789776
Registry record updated Sep 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
LINCOLN HEIGHTS URGENT CARE
Practice address
2813 N Broadway
Los Angeles, CA 90031-2611
Phone
(323) 342-9764
Fax
(323) 342-9656
NPI assigned
Sep 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2015

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

Authorized official

Name
Dr. Tomas A Sevilla, M.D.
Title
Owner
Phone
(323) 342-9764

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

2813 N Broadway
Los Angeles, CA 90031-2611

Mailing address

2813 N Broadway
Los Angeles, CA 90031-2611

Other identifiers 1

IdentifierTypeStateIssuer
A63670MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442016000000",
    "number": "1053789776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2813 N BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2813 N BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312611",
            "telephone_number": "323-342-9764",
            "fax_number": "323-342-9656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN HEIGHTS URGENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-11",
        "last_updated": "2015-09-12",
        "status": "A",
        "authorized_official_last_name": "SEVILLA",
        "authorized_official_first_name": "TOMAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-342-9764",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A63670",
            "state": "CA"
        }
    ],
    "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 Sep 12, 2015; 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.