Sunmoon Urgent Care Medical Group Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

W17844 Issued in CA

Legal business name

SUNMOON URGENT CARE MEDICAL GROUP INC

Practice address

1161 1/2 Logan St
Los Angeles, CA 90026-3210

Phone

(213) 484-1289

Fax

(213) 484-2339

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Xia LiNPI 1659467728

Title

MD

Phone

(213) 484-1289

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

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

• Xia Li

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659467728
  Medicare reassignment NPD Authorized official
• Xinming Fu, MD

  • Internal Medicine Physician
  • Santa Ana, CA
  • NPI 1255381232
  NPD (past)
• Hasmik Harutyunyan, RDMS,RDCS,RVT

  • Sonography Radiologic Technologist
  • Los Angeles, CA
  • NPI 1649263229
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1144316217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 573",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917540573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 1/2 LOGAN ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900263210",
            "telephone_number": "213-484-1289",
            "fax_number": "213-484-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNMOON URGENT CARE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "XIA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "213-484-1289"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "W17844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A845840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunkwa African Art and Craft (Lifeline Community Clinic)
• Sunkwa Community Foundation (LifeLine community Clinic)
• Sunlight Group, PBC (Sunlight Health)
• Sunlite Pharmaceutical Inc (Pico Pharmacy)
• Sunmin Park MD a California Medical Corporation
• Gavraj Sunner
• Sunny Road Therapy Inc.
• Sunny S Chae (Zenith Prescription Pharmacy)
• Sunnyview Convalescent Hospital LLC
• Sunray Operating Company LLC (Sunray Healthcare Center)

• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.