NPIMap

Organization Active NPI

St. Isabel Family Medical Clinic, Inc.

  • Primary Care Clinic/Center
  • Harbor City, CA
National Provider Identifier
1700057981
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
37220 Issued in CA
Legal business name
ST. ISABEL FAMILY MEDICAL CLINIC, INC.
Practice address
1535 Lomita Blvd
Harbor City, CA 90710
Phone
(310) 530-9300
Fax
(310) 530-9303
NPI assigned
Mar 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Authorized official

Name
Edilita De Boda, PA-CNPI 1982892956
Title
President
Phone
(310) 530-9300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 37220 CA Primary

Addresses

Primary practice location

1535 Lomita Blvd
Harbor City, CA 90710

Mailing address

1535 Lomita Blvd
Harbor City, CA 90710
Phone (310) 530-9300

National Provider Directory

National Provider Directory

Locations

1535 Lomita Blvd
Harbor City, CA 90710
Phone (310) 530-9300

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1700057981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 LOMITA BLVD",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "90710",
            "telephone_number": "310-530-9300",
            "fax_number": "310-530-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 LOMITA BLVD",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "90710",
            "telephone_number": "310-530-9300",
            "fax_number": "310-530-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ISABEL FAMILY MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "DE BODA",
        "authorized_official_first_name": "EDILITA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-530-9300",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "37220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harbor City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.