NPIMap

Organization Active NPI

Southern California Immediate Medical Center

  • Specialist
  • La Mirada, CA
National Provider Identifier
1205041290
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
20 A5386 Issued in CA
Legal business name
SOUTHERN CALIFORNIA IMMEDIATE MEDICAL CENTER
Practice address
15330 Valley View Ave Ste 1
La Mirada, CA 90638-5238
Phone
(562) 802-0208
Fax
(562) 802-0999
NPI assigned
May 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Thonas Roccapalumbo, DO
Title
Medical Director
Phone
(323) 726-3212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 20 A5386 CA Primary

Addresses

Primary practice location

15330 Valley View Ave Ste 1
La Mirada, CA 90638-5238

Mailing address

7300 Alondra Blvd Ste 101
Paramount, CA 90723-4000
Phone (562) 531-8300

National Provider Directory

National Provider Directory
Tax ID family
Southern California Immediate Medical Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

15330 Valley View Ave
Ste 1
La Mirada, CA 90638
Phone (562) 802-0208

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205041290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 ALONDRA BLVD STE 101",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907234000",
            "telephone_number": "562-531-8300",
            "fax_number": "562-531-8035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15330 VALLEY VIEW AVE STE 1",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906385238",
            "telephone_number": "562-802-0208",
            "fax_number": "562-802-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA IMMEDIATE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROCCAPALUMBO",
        "authorized_official_first_name": "THONAS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "323-726-3212",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "20 A5386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mirada, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.