Ernesto L. Fontecha, MD, Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

A36618 Issued in CA

Legal business name

ERNESTO L. FONTECHA, MD, INC

Practice address

159 S Vermont Ave
Los Angeles, CA 90004-5904

Phone

(213) 388-2044

Fax

(213) 632-0140

NPI assigned

Jan 13, 2016

Organization subpart

No

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

Authorized official

Name

Ernesto Fontecha, MD

Title

Ceo

Phone

(213) 388-2044

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511740800000",
    "number": "1306202833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900045904",
            "telephone_number": "213-388-2044",
            "fax_number": "213-632-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900045904",
            "telephone_number": "213-388-2044",
            "fax_number": "213-632-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERNESTO L. FONTECHA, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-13",
        "last_updated": "2017-11-27",
        "status": "A",
        "authorized_official_last_name": "FONTECHA",
        "authorized_official_first_name": "ERNESTO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-388-2044",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A36618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A36618",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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 Nov 27, 2017; 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.