Organization Active NPI

Policlinica Familiar San Judas Inc

  • Family Medicine Physician
  • East Los Angeles, CA
National Provider Identifier
1194071753
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A48644 Issued in CA
Legal business name
POLICLINICA FAMILIAR SAN JUDAS INC
Practice address
6007 Whittier Blvd
East Los Angeles, CA 90022-4401
Phone
(323) 725-1144
Fax
(323) 725-1153
NPI assigned
Jul 31, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

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

Authorized official

Name
Mrs. Gladis N. Funes, FAMILY NURSE PRACTIT
Title
Nurse Practitioner
Phone
(323) 725-1144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A48644 CA Primary

Addresses

Primary practice location

6007 Whittier Blvd
East Los Angeles, CA 90022-4401

Mailing address

6007 Whittier Blvd
East Los Angeles, CA 90022-4401
Phone (323) 725-1144

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.

NPI Registry JSON

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390435200000",
    "number": "1194071753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6007 WHITTIER BLVD",
            "city": "EAST LOS ANGELES",
            "state": "CA",
            "postal_code": "900224401",
            "telephone_number": "323-725-1144",
            "fax_number": "323-725-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6007 WHITTIER BLVD",
            "city": "EAST LOS ANGELES",
            "state": "CA",
            "postal_code": "900224401",
            "telephone_number": "323-725-1144",
            "fax_number": "323-725-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLICLINICA FAMILIAR SAN JUDAS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-31",
        "last_updated": "2014-01-23",
        "status": "A",
        "authorized_official_last_name": "FUNES",
        "authorized_official_first_name": "GLADIS",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "323-725-1144",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FAMILY NURSE PRACTIT"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A48644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.