Organization Active NPI

La Loma Medical Office, Inc.

  • Internal Medicine Physician
  • Oakland, CA
National Provider Identifier
1124165055
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LA LOMA MEDICAL OFFICE, INC.
Practice address
3022 International Blvd
Suite 312
Oakland, CA 94601-2224
Phone
(510) 261-1677
Fax
(510) 261-1650
NPI assigned
Jan 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Dr. Esteban Daniel Lovato, M DNPI 1376610923
Title
Physician
Phone
(510) 261-1677

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3022 International Blvd
Suite 312
Oakland, CA 94601-2224

Mailing address

3022 International Blvd
Suite 312
Oakland, CA 94601-2224
Phone (510) 261-1677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110513000601 CA Part B Supplier - Clinic/Group Practice 2567648280 Receives reassigned benefits from 1 practitioner
Practice locations: Oakland, CA; Stockton, 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
05D0926018La Loma Medical Office, Inc3022 International Blvd, Ste 312, Oakland, CA 94601Certificate of waiverJun 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
La Loma Medical Group Inc 22 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1339 S Madison St
Stockton, CA 95206
Phone (209) 460-1900

10 E Dr Martin Luther King Jr Blvd
Stockton, CA 95206
Phone (209) 460-1900

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FFHIAD

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1124165055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3022 INTERNATIONAL BLVD",
            "address_2": "SUITE 312",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012224",
            "telephone_number": "510-261-1677",
            "fax_number": "510-261-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3022 INTERNATIONAL BLVD",
            "address_2": "SUITE 312",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012224",
            "telephone_number": "510-261-1677",
            "fax_number": "510-261-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA LOMA MEDICAL OFFICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "LOVATO",
        "authorized_official_first_name": "ESTEBAN",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "510-261-1677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.