Calvary Medical Clinic, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

A53229 Issued in CA

Legal business name

CALVARY MEDICAL CLINIC, INC.

Practice address

11502 S Vermont Ave
Suite a
Los Angeles, CA 90044-6522

Phone

(323) 757-1557

Fax

(323) 757-1461

NPI assigned

Mar 23, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Christopher Chiedu Okafor, M.D.

Title

President

Phone

(323) 757-1557

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GGFJAA

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237766400000",
    "number": "1295976199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11502 S VERMONT AVE",
            "address_2": "SUITE A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900446522",
            "telephone_number": "323-757-1557",
            "fax_number": "323-757-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11502 S VERMONT AVE",
            "address_2": "SUITE A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900446522",
            "telephone_number": "323-757-1557",
            "fax_number": "323-757-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALVARY MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-23",
        "last_updated": "2009-03-23",
        "status": "A",
        "authorized_official_last_name": "OKAFOR",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "CHIEDU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-757-1557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A53229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336275981",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Calrecup Care, Inc
• Joan Calton
• Daniel Ramos Caluag I
• Feliza Angeline Calub, NP
• Renato Limen Calugcugan, D.M.D.
• Lauren Calvert, MD
• Jenelle L Calvez
• Linda Calvillo King, MD
• Ashley Marie Calvillo
• Julio Calvillo

• Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; 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.