NPIMap

Organization Active NPI

Medipro Inc.

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1376580894
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G53815 Issued in CA
Legal business name
MEDIPRO INC.
Practice address
1828 S Western Ave
Suite 10
Los Angeles, CA 90006-5808
Phone
(323) 730-0310
Fax
(323) 735-2743
NPI assigned
Jun 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Joseph Emanuel Pierson III, M.D.NPI 1457376790
Title
Ceo/President
Phone
(323) 730-0310

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
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X G53815 CA Primary

Addresses

Primary practice location

1828 S Western Ave
Suite 10
Los Angeles, CA 90006-5808

Mailing address

1828 S Western Ave
Suite 10
Los Angeles, CA 90006-5808
Phone (323) 730-0310

Other identifiers 3

IdentifierTypeStateIssuer
GR0063272MedicaidCA
GR0063270MedicaidCA
G53815OtherCAPROVIDER MEDICAL LICENSE

Other names 1

  • Mediplus Multispeciality Medical Grp. Doing business as

National Provider Directory

National Provider Directory

Locations

1828 S Western Ave
Ste 10
Los Angeles, CA 90006
Phone (323) 730-0310

1818 S Western Ave
Ste 300
Los Angeles, CA 90006
Phone (323) 373-0890

1828 S Western Ave
Ste 11
Los Angeles, CA 90006
Phone (323) 730-0310

3611 Martin Luther King Jr Blvd
Ste 102
Lynwood, CA 90262
Phone (213) 730-0310

4712 Admiralty Way
#556
Marina del Rey, CA 90292

Practitioners & affiliated clinicians

Practitioners 7

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": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376580894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 S WESTERN AVE",
            "address_2": "SUITE 10",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900065808",
            "telephone_number": "323-730-0310",
            "fax_number": "323-735-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 S WESTERN AVE",
            "address_2": "SUITE 10",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900065808",
            "telephone_number": "323-730-0310",
            "fax_number": "323-735-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIPRO INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PIERSON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "EMANUEL",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "323-730-0310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G53815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0063272",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0063270",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER MEDICAL LICENSE",
            "identifier": "G53815",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mediplus Multispeciality Medical Grp.",
            "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 Aug 22, 2020; 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.