NPIMap

Organization Active NPI

JML Medical Group Inc

Doing business as East LA Family Clinic

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1275278608
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JML MEDICAL GROUP INC
Doing business as
East LA Family Clinic
Practice address
5400 E Beverly Blvd
Los Angeles, CA 90022-2208
Phone
(626) 673-5439
NPI assigned
Apr 29, 2022
Last updated
Oct 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Authorized official

Name
Eddie Lares, MD
Title
Director
Phone
(626) 673-5439

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Non-Surgical Family Planning Clinic/Center 261QF0050X NU

Addresses

Primary practice location

5400 E Beverly Blvd
Los Angeles, CA 90022-2208

Mailing address

4200 Peck Rd Ste B
El Monte, CA 91732-2177
Phone (626) 673-5439

Other identifiers 1

IdentifierTypeStateIssuer
A107364MedicaidCA

Other names 1

  • East LA Family Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
East la Family Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

4200 Peck Rd
Ste B
El Monte, CA 91732
Phone (626) 350-5073

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": "1651190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1275278608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 PECK RD STE B",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917322177",
            "telephone_number": "626-673-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 E BEVERLY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900222208",
            "telephone_number": "626-673-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JML MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "LARES",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "626-673-5439",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A107364",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East LA Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East LA Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 29, 2024; 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.