NPIMap

Organization Active NPI

Altamed SBC Pace East Los Angeles

  • Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1083823488
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
A107932 Issued in CA
Legal business name
ALTAMED SBC PACE EAST LOS ANGELES
Practice address
5425 Pomona Blvd
Los Angeles, CA 90022-1716
Phone
(617) 407-9515
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Authorized official

Name
Dr. Michael E. Hochman, MD
Title
Medical Director, Innovation
Phone
(617) 407-9515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X A107932 CA Primary

Addresses

Primary practice location

5425 Pomona Blvd
Los Angeles, CA 90022-1716

Mailing address

5425 Pomona Blvd
Los Angeles, CA 90022-1716
Phone (617) 407-9515

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1083823488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 POMONA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221716",
            "telephone_number": "617-407-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 POMONA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221716",
            "telephone_number": "617-407-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTAMED SBC PACE EAST LOS ANGELES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "HOCHMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR, INNOVATION",
        "authorized_official_telephone_number": "617-407-9515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A107932",
            "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 Apr 26, 2012; 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.