NPIMap

Organization Active NPI

Icm Medical Group, Inc.

  • Pulmonary Disease Physician
  • Inglewood, CA
National Provider Identifier
1467401000
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
2825600 Issued in CA
Legal business name
ICM MEDICAL GROUP, INC.
Practice address
211 N Prairie Ave
Inglewood, CA 90301-1412
Phone
(310) 673-4000
Fax
(310) 673-4001
NPI assigned
May 10, 2006
Last updated
Sep 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Authorized official

Name
Dr. Amanuel Sima, M.D.NPI 1366493744
Title
President
Phone
(310) 989-1224

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
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X 2825600 CA Primary

Addresses

Primary practice location

211 N Prairie Ave
Inglewood, CA 90301-1412

Mailing address

PO Box 1698
Inglewood, CA 90308-1698
Phone (310) 673-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061020000336 CA Part B Supplier - Clinic/Group Practice 6709882491 Receives reassigned benefits from 6 practitioners
Practice locations: Inglewood, CA; Beverly Hills, CA

National Provider Directory

National Provider Directory
Tax ID family
Icm Medical Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

50 N La Cienega Blvd
Ste 220
Beverly Hills, CA 90211
Phone (310) 288-0808

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758585600000",
    "number": "1467401000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1698",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903081698",
            "telephone_number": "310-673-4000",
            "fax_number": "310-673-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N PRAIRIE AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011412",
            "telephone_number": "310-673-4000",
            "fax_number": "310-673-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICM MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A",
        "authorized_official_last_name": "SIMA",
        "authorized_official_first_name": "AMANUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-989-1224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "2825600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.