San Angel Medical Clinic, Inc.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

G86496 Issued in CA

Legal business name

SAN ANGEL MEDICAL CLINIC, INC.

Practice address

2661 E Florence Ave
Suuite D-1
Huntington Park, CA 90255-4793

Phone

(323) 588-6113

NPI assigned

Jul 19, 2007

Last updated

Sep 20, 2013By 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

Stephine Kramer, M.D.

Title

Medical Director

Phone

(323) 588-6113

Specialties & licenses 4

Addresses

Other identifiers 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.

• Austin Vannath Plong, PA-C

  • Physician Assistant
  • Huntington Park, CA
  • NPI 1366622433
  NPD (past)
• Nayan R. Shah, M.D.

  • Family Medicine Physician
  • Chino, CA
  • NPI 1457365553
  NPD (past)
• Yolanda A. Zapanta-Novero, M.D.

  • Pediatrics Physician
  • Paramount, CA
  • NPI 1457452310
  NPD (past)

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379635200000",
    "number": "1699975557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2661 E FLORENCE AVE",
            "address_2": "SUUITE D-1",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902554793",
            "telephone_number": "323-588-6113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2661 E FLORENCE AVE",
            "address_2": "SUUITE D-1",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902554793",
            "telephone_number": "323-588-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANGEL MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2013-09-20",
        "status": "A",
        "authorized_official_last_name": "KRAMER",
        "authorized_official_first_name": "STEPHINE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "323-588-6113",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15560",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A44599",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G86496",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A52088",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0100930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Huntington Park, CA
• Providers in Huntington Park, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.