St. Luke Medical Center Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A34603 Issued in CA

Legal business name

ST. LUKE MEDICAL CENTER INC.

Practice address

3705 Gage Ave Ste a
Bell, CA 90201-1024

Phone

(310) 720-2507

Fax

(310) 219-0497

NPI assigned

Oct 8, 2012

Last updated

Oct 8, 2012By 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

Daisy Vargas

Title

Manager

Phone

(310) 720-2507

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349654400000",
    "number": "1558613059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 GAGE AVE STE A",
            "city": "BELL",
            "state": "CA",
            "postal_code": "902011024",
            "telephone_number": "310-720-2507",
            "fax_number": "310-219-0497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 GAGE AVE STE A",
            "city": "BELL",
            "state": "CA",
            "postal_code": "902011024",
            "telephone_number": "310-720-2507",
            "fax_number": "310-219-0497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE MEDICAL CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-08",
        "status": "A",
        "authorized_official_last_name": "VARGAS",
        "authorized_official_first_name": "DAISY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "310-720-2507"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A34603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A34603",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Soto
• Southern California Pulmonary Specialist Group
• Special Care 4 Special Smile
• St Jude Medical Center (n/a)
• St Kerollos Pharmacy Inc (American Home Pharmacy)
• St.Mary and St George Dental Center
• The Medicine Cabinet Inc. (The Medicine Cabinet #5)
• The Salvation Army Bell Shelter
• Tamyra Ann Thomas
• Tita & Ernesto Padayao (Bell Drugs)

• Family Medicine Physician in Bell, CA
• Providers in Bell, 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 Oct 8, 2012; 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.