Organization Active NPI

Kamali Medical Corporation

  • Specialist
  • Lakewood, CA
National Provider Identifier
1427084987
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
KAMALI MEDICAL CORPORATION
Practice address
5750 Downey Ave
Suite 202
Lakewood, CA 90712-1405
Phone
(562) 634-4939
Fax
(562) 634-5809
NPI assigned
Jun 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Authorized official

Name
Jose L Pantoja, M.D.NPI 1891721353
Title
President
Phone
(562) 634-4939

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: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

5750 Downey Ave
Suite 202
Lakewood, CA 90712-1405

Mailing address

PO Box 666
Artesia, CA 90702-0666
Phone (562) 634-4939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070202000372 CA Part B Supplier - Clinic/Group Practice 0749282895 Receives reassigned benefits from 2 practitioners
Practice locations: Lakewood, CA

National Provider Directory

National Provider Directory

Locations

5750 Downey Ave
Ste 202
Lakewood, CA 90712
Phone (562) 634-4939

Practitioners & affiliated clinicians

Practitioners 2

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": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194912000000",
    "number": "1427084987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 666",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907020666",
            "telephone_number": "562-634-4939",
            "fax_number": "562-634-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 DOWNEY AVE",
            "address_2": "SUITE 202",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121405",
            "telephone_number": "562-634-4939",
            "fax_number": "562-634-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAMALI MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2007-11-13",
        "status": "A",
        "authorized_official_last_name": "PANTOJA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-634-4939",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.