Doctor Paul Memorial Medical Center

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

A53449 Issued in CA

Legal business name

DOCTOR PAUL MEMORIAL MEDICAL CENTER

Practice address

501 E Hardy St Ste 220
Inglewood, CA 90301-4054

Phone

(323) 290-2832

Fax

(323) 290-2836

NPI assigned

Jul 13, 2005

Last updated

Aug 6, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

0000992894-0001-6As reported in NPPES

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

Authorized official

Name

Dr. Mezia Ogugua Azinge, M.D.

Title

President/Ceo

Phone

(323) 290-2832

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Part of

Doctor Paul Memorial Medical Center

Locations

Interoperability endpoints

• Direct secure messaging: mezia_azingeobasi@direct.myupdox.com

Practitioners 2

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.

• Immaculate Obiageli Anebere, NP

  • Family Nurse Practitioner
  • Inglewood, CA
  • NPI 1720697683
  Medicare reassignment Care Compare group NPD
• Francis Chukwuemeka Obi, D.O.

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1841659174
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596672000000",
    "number": "1659379634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E HARDY ST STE 220",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014054",
            "telephone_number": "323-290-2832",
            "fax_number": "323-290-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E HARDY ST STE 220",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014054",
            "telephone_number": "323-290-2832",
            "fax_number": "323-290-2836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6325 Topanga Canyon Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Woodland Hills",
            "state": "CA",
            "postal_code": "913672015",
            "country_code": "US",
            "telephone_number": "818-650-2595",
            "fax_number": "323-290-2836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DOCTOR PAUL MEMORIAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "0000992894-0001-6",
        "enumeration_date": "2005-07-13",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A",
        "authorized_official_last_name": "AZINGE",
        "authorized_official_first_name": "MEZIA",
        "authorized_official_middle_name": "OGUGUA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "323-290-2832",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A53449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A534491",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A534492",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A53449",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mezia_azingeobasi@direct.myupdox.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "501 E Hardy St Ste 220",
            "city": "Inglewood",
            "state": "CA",
            "country_code": "US",
            "postal_code": "903014054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aisha Chantel Mayfield Dioum
• Divine Healthcare Services,Inc
• Divine Solutions Alliance
• Michelle Sherron Dixon
• Tamara L Dixon, D.D.S.
• Eve D Domacena
• Abigail Ann Constantino Domingo, NP
• Jacqueline Dominguez
• Domtek Medical&Allied Services Inc
• Frances Donison

• Clinic/Center in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.