NPIMap

Organization Active NPI

Los Alamitos Internal Medical Group Inc

Doing business as Los Alamitos Cardiovascular

  • Specialist
  • Los Alamitos, CA
National Provider Identifier
1720035686
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A73497 Issued in CA
Legal business name
LOS ALAMITOS INTERNAL MEDICAL GROUP INC
Doing business as
Los Alamitos Cardiovascular
Practice address
5300 Katella Ave
Los Alamitos, CA 90720-2808
Phone
(562) 430-7533
Fax
(562) 430-8055
NPI assigned
May 27, 2006
Last updated
Sep 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Authorized official

Name
Dr. Steven T. Forman, M.D.NPI 1023059763
Title
President
Phone
(562) 430-7533

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X A73497 CA Primary

Addresses

Primary practice location

5300 Katella Ave
Los Alamitos, CA 90720-2808

Mailing address

5300 Katella Ave
Los Alamitos, CA 90720-2808
Phone (562) 430-7533

Other names 1

  • LOS ALAMITOS CARDIOVASCULAR Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050126001139 CA Part B Supplier - Clinic/Group Practice 6507816642 Receives reassigned benefits from 9 practitioners
Practice locations: Los Alamitos, CA

National Provider Directory

National Provider Directory

Locations

3771 Katella Ave
Los Alamitos, CA 90720
Phone (562) 742-7116

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1720035686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 KATELLA AVE",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202808",
            "telephone_number": "562-430-7533",
            "fax_number": "562-430-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 KATELLA AVE",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202808",
            "telephone_number": "562-430-7533",
            "fax_number": "562-430-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ALAMITOS INTERNAL MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A",
        "authorized_official_last_name": "FORMAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-430-7533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A73497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LOS ALAMITOS CARDIOVASCULAR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.