NPIMap

Organization Active NPI

Huntington Park Clinica Medica General, Medical Center, Inc

  • Family Medicine Physician
  • El Monte, CA
National Provider Identifier
1477194082
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HUNTINGTON PARK CLINICA MEDICA GENERAL, MEDICAL CENTER, INC
Doing business as
Huntington Park Clinica Medica General, Medical Center, Inc
Practice address
11026 Valley Mall
El Monte, CA 91731-2617
Phone
(213) 739-3282
Fax
(626) 443-9646
NPI assigned
Oct 4, 2019
Last updated
Oct 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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

Authorized official

Name
Jose Luis Carrillo Jr., DO
Title
Office Manager
Phone
(213) 739-3282

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

11026 Valley Mall
El Monte, CA 91731-2617

Mailing address

PO Box 1682
Beverly Hills, CA 90213-1682
Phone (213) 739-3282

Other names 1

  • Huntington Park Clinica Medica General, Medical Center, Inc Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL lacmg.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Huntington Park Clinica Medica General Medical Center Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570147200000",
    "number": "1477194082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1682",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902131682",
            "telephone_number": "213-739-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11026 VALLEY MALL",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917312617",
            "telephone_number": "213-739-3282",
            "fax_number": "626-443-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUNTINGTON PARK CLINICA MEDICA GENERAL, MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-04",
        "last_updated": "2019-10-04",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "213-739-3282",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "lacmg.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11026 Valley Mall",
            "city": "El Monte",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917312617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Huntington Park Clinica Medica General, Medical Center, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Monte, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; 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.