NPIMap

Organization Active NPI

Integrated Medical Center Dtla PC

  • Chiropractor
  • Los Angeles, CA
National Provider Identifier
1124754627
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
INTEGRATED MEDICAL CENTER DTLA PC
Practice address
1055 Wilshire Blvd Ste 1930
Los Angeles, CA 90017-5602
Phone
(310) 259-7748
NPI assigned
Jul 27, 2022
Last updated
Aug 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Authorized official

Name
Paulo VillanuevaNPI 1710113113
Title
Authorized Official
Phone
(310) 259-7748

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1055 Wilshire Blvd Ste 1930
Los Angeles, CA 90017-5602

Mailing address

1055 Wilshire Blvd Ste 1930
Los Angeles, CA 90017-5602

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661385600000",
    "number": "1124754627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 WILSHIRE BLVD STE 1930",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900175602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 WILSHIRE BLVD STE 1930",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900175602",
            "telephone_number": "310-259-7748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL CENTER DTLA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A",
        "authorized_official_last_name": "VILLANUEVA",
        "authorized_official_first_name": "PAULO",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "310-259-7748"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "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 Aug 25, 2022; 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.