L a Star Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A56273 Issued in CA

Legal business name

L A STAR MEDICAL GROUP, INC.

Practice address

10132 California Ave
South Gate, CA 90280-6008

Phone

(323) 566-4411

Fax

(323) 566-0390

NPI assigned

Jun 11, 2015

Last updated

Jun 11, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Emile Shenouda, MDNPI 1760596845

Title

President

Phone

(323) 566-4411

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Emile George Shenouda, MD

  • Pediatrics Physician
  • South Gate, CA
  • NPI 1760596845
  NPD Authorized official

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1386025773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10132 CALIFORNIA AVE",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806008",
            "telephone_number": "323-566-4411",
            "fax_number": "323-566-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10132 CALIFORNIA AVE",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806008",
            "telephone_number": "323-566-4411",
            "fax_number": "323-566-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L A STAR MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "SHENOUDA",
        "authorized_official_first_name": "EMILE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-566-4411",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A56273",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A56273",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Sangho Kim, DDS
• Terry Kim, PHARMD, RPH
• Jonathan Kiriboon, OD
• Travone Knight
• Irina Kumar, P.A.
• La Libertad Medical Clinic Inc
• La Libertad Medical Clinic Inc
• Jovanna Laborin
• Rudy Joe Lafargo Jr.
• Jesus Guadalupe Landeros

• Family Medicine Physician in South Gate, CA
• Providers in South Gate, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; 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.