NPIMap

Organization Active NPI

San Cristobal Medical Group Inc.

  • Exclusive Provider Organization
  • Los Angeles, CA
National Provider Identifier
1497781579
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
FNP 24915 Issued in CA
Legal business name
SAN CRISTOBAL MEDICAL GROUP INC.
Practice address
1930 Wilshire Blvd
Suite 405
Los Angeles, CA 90057-3605
Phone
(213) 413-1890
NPI assigned
Jun 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Amos Cheerkey Acoff, M.D.
Title
President
Phone
(213) 413-4203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X FNP 24915 CA Primary

Addresses

Primary practice location

1930 Wilshire Blvd
Suite 405
Los Angeles, CA 90057-3605

Mailing address

1930 Wilshire Blvd
Suite 410
Los Angeles, CA 90057-3605
Phone (213) 413-4203

National Provider Directory

National Provider Directory
Tax ID family
San Cristobal Medical Group Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

1930 Wilshire Blvd
Ste 405
Los Angeles, CA 90057
Phone (213) 413-1890

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497781579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 WILSHIRE BLVD",
            "address_2": "SUITE 410",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573605",
            "telephone_number": "213-413-4203",
            "fax_number": "213-413-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 WILSHIRE BLVD",
            "address_2": "SUITE 405",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573605",
            "telephone_number": "213-413-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN CRISTOBAL MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ACOFF",
        "authorized_official_first_name": "AMOS",
        "authorized_official_middle_name": "CHEERKEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-413-4203",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CA",
            "license": "FNP 24915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.