NPIMap

Organization Active NPI

Ardmore Medical Group Inc

  • General Practice Physician
  • Los Angeles, CA
National Provider Identifier
1124189212
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ARDMORE MEDICAL GROUP INC
Practice address
3518 W 8TH St
Los Angeles, CA 90005-2902
Phone
(213) 384-9949
Fax
(213) 384-2530
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

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

Authorized official

Name
Dr. Alan K Kims, M.D.
Title
President
Phone
(323) 562-6170

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

3518 W 8TH St
Los Angeles, CA 90005-2902

Mailing address

5953 Atlantic Blvd
Maywood, CA 90270-3133
Phone (323) 562-6170

Other names 1

  • CLINICA HUMANITARIA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070809000171 CA Part B Supplier - Clinic/Group Practice 6901997634 Receives reassigned benefits from 5 practitioners
3 other NPIs on this enrollment
Practice locations: Maywood, CA; Los Angeles, CA; Huntington Park, CA; El Monte, CA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430352000000",
    "number": "1124189212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5953 ATLANTIC BLVD",
            "city": "MAYWOOD",
            "state": "CA",
            "postal_code": "902703133",
            "telephone_number": "323-562-6170",
            "fax_number": "323-562-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3518 W 8TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900052902",
            "telephone_number": "213-384-9949",
            "fax_number": "213-384-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARDMORE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2015-04-30",
        "status": "A",
        "authorized_official_last_name": "KIMS",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-562-6170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINICA HUMANITARIA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 30, 2015; 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.