Organization Active NPI

St. Francis Multispecialty Medical Group, Inc.

  • Family Medicine Physician
  • Lynwood, CA
National Provider Identifier
1497964548
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST. FRANCIS MULTISPECIALTY MEDICAL GROUP, INC.
Practice address
3628 E Imperial Hwy
Suite #303
Lynwood, CA 90262-2643
Phone
(310) 900-7360
NPI assigned
May 22, 2007
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
Mrs. Marcie Martinez
Title
Account Manager
Phone
(714) 452-1961

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3628 E Imperial Hwy
Suite #303
Lynwood, CA 90262-2643

Mailing address

3621 Martin Luther King Jr Blvd
Suite #8
Lynwood, CA 90262-3512
Phone (310) 637-0677

Other identifiers 1

IdentifierTypeStateIssuer
GR0080600MedicaidCA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0899033St Francis Multispecialty Medical Group, Inc3628 E Imperial Highway Ste 303, Lynwood, CA 90262Certificate of waiverOct 30, 2026

National Provider Directory

National Provider Directory

Locations

3621 Martin Luther King Jr Blvd
Ste 8
Lynwood, CA 90262
Phone (310) 637-0677

Practitioners & affiliated clinicians

Practitioners 3

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": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497964548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE #8",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623512",
            "telephone_number": "310-637-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3628 E IMPERIAL HWY",
            "address_2": "SUITE #303",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622643",
            "telephone_number": "310-900-7360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. FRANCIS MULTISPECIALTY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "MARCIE",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "714-452-1961",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0080600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.