Organization Active NPI

Santa Elena Medical Center, Inc.

  • General Practice Physician
  • Pico Rivera, CA
National Provider Identifier
1265617393
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
SANTA ELENA MEDICAL CENTER, INC.
Practice address
5036 Passons Blvd.
Suite 2
Pico Rivera, CA 90660
Phone
(562) 654-2800
Fax
(562) 654-2802
NPI assigned
Jan 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Authorized official

Name
Richard Park, M.D.NPI 1174718134
Title
Ceo
Phone
(562) 654-2800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

5036 Passons Blvd.
Suite 2
Pico Rivera, CA 90660

Mailing address

5036 Passons Blvd Ste 2
Pico Rivera, CA 90660-2864
Phone (562) 654-2800

Other names 1

  • santa elena medical care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210726001289 CA Part B Supplier - Clinic/Group Practice 6103951702 Receives reassigned benefits from 2 practitioners
Practice locations: Pico Rivera, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781481600000",
    "number": "1265617393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5036 PASSONS BLVD STE 2",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906602864",
            "telephone_number": "562-654-2800",
            "fax_number": "562-654-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5036 PASSONS BLVD.",
            "address_2": "SUITE 2",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "90660",
            "telephone_number": "562-654-2800",
            "fax_number": "562-654-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA ELENA MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-654-2800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "santa elena medical care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pico Rivera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; 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.