Mid City Associated Medical Group, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A44112 Issued in CA

Legal business name

MID CITY ASSOCIATED MEDICAL GROUP, INC.

Doing business as

CLINICA DE SALUD FAMILIAR

Practice address

1039 S Alvarado St
Los Angeles, CA 90006-3711

Phone

(213) 388-0000

Fax

(818) 361-7584

NPI assigned

Dec 27, 2006

Organization subpart

No

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

Authorized official

Name

Jorge Antonio Almendares

Title

Administrator

Phone

(213) 388-0000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CLINICA DE SALUD FAMILIAR Doing business as

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1386709335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1039 S ALVARADO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900063711",
            "telephone_number": "213-388-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 S ALVARADO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900063711",
            "telephone_number": "213-388-0000",
            "fax_number": "818-361-7584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID CITY ASSOCIATED MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "ALMENDARES",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "213-388-0000"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A44112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0043090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINICA DE SALUD FAMILIAR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.