NPIMap

Organization Active NPI

Samaritana Medical Clinic,Inc.

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1073706289
Registry record updated Dec 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A75748 Issued in CA
Legal business name
SAMARITANA MEDICAL CLINIC,INC.
Practice address
510 S Alvarado St
Los Angeles, CA 90057-2904
Phone
(213) 483-3600
Fax
(213) 483-4555
NPI assigned
Aug 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2017

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

Authorized official

Name
Raymundo Romero, MDNPI 1568537314
Title
Director
Phone
(323) 264-7238

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 2047059 CA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X A75748 CA Primary

Addresses

Primary practice location

510 S Alvarado St
Los Angeles, CA 90057-2904

Mailing address

510 S Alvarado St
Los Angeles, CA 90057-2904
Phone (213) 483-3600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100201000224 CA Part B Supplier - Clinic/Group Practice 0749370989 Receives reassigned benefits from 26 practitioners
Practice locations: South Gate, CA; Los Angeles, CA; La Puente, CA; Duarte, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1063079Samaritana Medical Clinic, Inc510 S Alvarado St, Los Angeles, CA 90057Certificate of waiverDec 8, 2026

National Provider Directory

National Provider Directory

Locations

7418 State St
Huntington Park, CA 90255
Phone (323) 835-6298

4055 E Olympic Blvd
Ste 210
Los Angeles, CA 90023
Phone (323) 268-3491

2033 W 7th St
Ste 3
Los Angeles, CA 90057
Phone (213) 484-2288

1101 N Vermont Ave
#I
Los Angeles, CA 90029
Phone (323) 665-4230

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514246400000",
    "number": "1073706289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 S ALVARADO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572904",
            "telephone_number": "213-483-3600",
            "fax_number": "213-483-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S ALVARADO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572904",
            "telephone_number": "213-483-3600",
            "fax_number": "213-483-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITANA MEDICAL CLINIC,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2017-12-26",
        "status": "A",
        "authorized_official_last_name": "ROMERO",
        "authorized_official_first_name": "RAYMUNDO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "323-264-7238",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "2047059",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A75748",
            "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 Dec 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.