NPIMap

Organization Active NPI

El Monte Clinica Medica General Medical Center, Inc

  • Multi-Specialty Clinic/Center
  • El Monte, CA
National Provider Identifier
1093762593
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
EL MONTE CLINICA MEDICA GENERAL MEDICAL CENTER, INC
Practice address
11001 Main St Ste 301
El Monte, CA 91731-2620
Phone
(626) 443-4300
Fax
(626) 433-9646
NPI assigned
May 28, 2006
Last updated
Jul 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Authorized official

Name
Mr. Jose Luis Carrillo Jr.
Title
Business Accounts Manager
Phone
(213) 739-3282

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

11001 Main St Ste 301
El Monte, CA 91731-2620

Mailing address

PO Box 2013
Beverly Hills, CA 90213-2013
Phone (213) 637-2530

Other identifiers 1

IdentifierTypeStateIssuer
GR0076130MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040408000573 CA Part B Supplier - Clinic/Group Practice 5092708560 Receives reassigned benefits from 31 practitioners
Practice locations: El Monte, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689724800000",
    "number": "1093762593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2013",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902132013",
            "telephone_number": "213-637-2530",
            "fax_number": "213-384-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11001 MAIN ST STE 301",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917312620",
            "telephone_number": "626-443-4300",
            "fax_number": "626-433-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL MONTE CLINICA MEDICA GENERAL MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "BUSINESS ACCOUNTS MANAGER",
        "authorized_official_telephone_number": "213-739-3282",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0076130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Monte, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.