Main Medical Health Clinic Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MAIN MEDICAL HEALTH CLINIC INC

Practice address

23517 Main St Ste 108
Carson, CA 90745-5239

Phone

(310) 518-6246

Fax

(310) 518-6247

NPI assigned

Oct 14, 2019

Last updated

Mar 1, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Liezl A SantosNPI 1316479397

Title

NP

Phone

(310) 634-7127

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Liezl Santos

  • Family Nurse Practitioner
  • Downey, CA
  • NPI 1316479397
  NPD (past) Authorized official

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1538701206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23517 MAIN ST STE 108",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907455239",
            "telephone_number": "310-518-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23517 MAIN ST STE 108",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907455239",
            "telephone_number": "310-518-6246",
            "fax_number": "310-518-6247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN MEDICAL HEALTH CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-14",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "SANTOS",
        "authorized_official_first_name": "LIEZL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "310-634-7127"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Carson, CA
• Providers in Carson, 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 Mar 1, 2021; 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.