NPIMap

Ardmore Medical Group

Organization Active NPI Family Medicine Physician · El Monte, CA

NPI 1275627770 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1275627770
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
A44265 (CA)
Legal business name
ARDMORE MEDICAL GROUP
Practice address
3564 A Santa Anita Ave
El Monte, CA 91731
Phone
(626) 350-8101
Fax
(626) 442-0196
NPI assigned
Oct 2, 2006
Organization subpart
No

Authorized official

Name
Alan K Kims, MD
Title
President MD
Phone
(323) 562-6170

Corporate family (same tax ID) 17

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

National Provider Directory

Tax ID family
Ardmore Medical Group (18 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207Q00000X A44265 CA Yes

Addresses

Primary practice location

3564 A Santa Anita Ave
El Monte, CA 91731

Mailing address

5953 Atlantic Blvd
Maywood, CA 90270
Phone (323) 562-6170

Other names

  • Clinica Humanitar Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275627770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5953 ATLANTIC BLVD",
            "city": "MAYWOOD",
            "state": "CA",
            "postal_code": "90270",
            "telephone_number": "323-562-6170",
            "fax_number": "323-562-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3564 A SANTA ANITA AVE",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "91731",
            "telephone_number": "626-350-8101",
            "fax_number": "626-442-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARDMORE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIMS",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT MD",
        "authorized_official_telephone_number": "323-562-6170",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A44265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinica Humanitar",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Monte, CA

All providers in El Monte, CA · Family Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.