Toluca Lake Medical Clinic Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TOLUCA LAKE MEDICAL CLINIC INC

Practice address

4110 Cahuenga Blvd
Toluca Lake, CA 91602-2831

Phone

(747) 205-2095

Fax

(747) 205-2559

NPI assigned

Jul 15, 2025

Last updated

Jul 15, 2025By 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

Philip Kim, MDNPI 1356781132

Title

President

Phone

(747) 205-2095

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

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.

• Philip Kim, MD

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1356781132
  Medicare reassignment NPD Authorized official
• Karen Flores Alcantara, FNP-BC

  • Family Nurse Practitioner
  • Arleta, CA
  • NPI 1336826445
  Medicare reassignment NPD
• Alice Esame, MD

  • Family Medicine Physician
  • Mount Airy, MD
  • NPI 1457746406
  NPD

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

{
    "created_epoch": "1752537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752537600000",
    "number": "1598657645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 CAHUENGA BLVD",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022831",
            "telephone_number": "747-205-2095",
            "fax_number": "747-205-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 CAHUENGA BLVD",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022831",
            "telephone_number": "747-205-2095",
            "fax_number": "747-205-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOLUCA LAKE MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "747-205-2095",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toluca Acupuncture Center (Toluca Wholeness Center)
• Toluca Hospice Care, Inc.
• Toluca Lake Foot Institute Inc
• Toluca Lake Home Health Inc
• Toluca Lake Medical Center Inc
• Toluca Lake Medical Management
• Toluca Lake Medical Supply Inc
• Toluca Medical Group PC
• Traci Gunn, Marriage and Family Therapy Corporation
• Universal Surgery Center, L.L.C.

• Family Medicine Physician in Toluca Lake, CA
• Providers in Toluca Lake, 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 Jul 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.