Loyola Medical Center a Professional Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A39370 Issued in CA

Legal business name

LOYOLA MEDICAL CENTER A PROFESSIONAL CORPORATION

Practice address

4225 Tweedy Blvd
South Gate, CA 90280-6217

Phone

(323) 564-6464

Fax

(323) 564-8578

NPI assigned

Jun 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Carlos A Venegas, M.D.

Title

Director

Phone

(323) 564-6464

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360195200000",
    "number": "1467654590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 TWEEDY BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806217",
            "telephone_number": "323-564-6464",
            "fax_number": "323-564-8578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 TWEEDY BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806217",
            "telephone_number": "323-564-6464",
            "fax_number": "323-564-8578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOYOLA MEDICAL CENTER A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2013-02-07",
        "status": "A",
        "authorized_official_last_name": "VENEGAS",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "323-564-6464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A39370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A393700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Los Reyes Cliinica Medica, Inc
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• Los Reyes Medical Clinic, Inc
• Stanley Lowe, D.P.M.
• Loyola Family Health Center Professional Corporation
• Loyola Wellness Center
• Luis Moran DDS a Dental Corporation
• Modesto Luis, DDS
• Lulu L. Chen, MD Inc.
• Jay Lutsky, DMD

• 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 Feb 7, 2013; 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.