Samaritana Medical Clinic, Inc.-Washington

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SAMARITANA MEDICAL CLINIC, INC.-WASHINGTON

Practice address

122 E Washington Blvd
Los Angeles, CA 90015-3601

Phone

(213) 483-3600

Fax

(213) 483-4555

NPI assigned

Mar 16, 2021

Organization subpart

No

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

Authorized official

Name

William Martinez, PA

Title

President

Phone

(213) 500-5475

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619395200000",
    "number": "1649855008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E WASHINGTON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153601",
            "telephone_number": "213-483-3600",
            "fax_number": "213-483-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 E WASHINGTON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153601",
            "telephone_number": "213-483-3600",
            "fax_number": "213-483-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITANA MEDICAL CLINIC, INC.-WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-16",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-500-5475",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jack Ethan Samath
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• Karina Samayoa-Ortega
• Izaiah Samayoa

• Primary Care Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.