NPIMap

Organization Active NPI

Crystal Medical Center Inc

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1376965772
Registry record updated Jan 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CRYSTAL MEDICAL CENTER INC
Practice address
3700 Wilshire Blvd
Suite 441
Los Angeles, CA 90010-2901
Phone
(310) 256-6586
NPI assigned
Jan 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2014

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

Authorized official

Name
Ms. Esther Edem
Title
Manager
Phone
(310) 256-6586

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3700 Wilshire Blvd
Suite 441
Los Angeles, CA 90010-2901

Mailing address

3700 Wilshire Blvd
Suite 441
Los Angeles, CA 90010-2901

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1390176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390176000000",
    "number": "1376965772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 WILSHIRE BLVD",
            "address_2": "SUITE 441",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WILSHIRE BLVD",
            "address_2": "SUITE 441",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102901",
            "telephone_number": "310-256-6586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-20",
        "last_updated": "2014-01-20",
        "status": "A",
        "authorized_official_last_name": "EDEM",
        "authorized_official_first_name": "ESTHER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "310-256-6586",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 20, 2014; 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.