Organization Active NPI

Holy Cross Urgent Care, Inc

  • Urgent Care Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1750894879
Registry record updated Nov 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
HOLY CROSS URGENT CARE, INC
Practice address
4864 Santa Monica Blvd
Los Angeles, CA 90029-2634
Phone
(323) 661-2700
NPI assigned
Nov 11, 2017
Last updated
Nov 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2017

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

Authorized official

Name
Manuk ChulyanNPI 1881986826
Title
Ceo
Phone
(323) 661-2700

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
Urgent Care Clinic/Center 261QU0200X CA Primary

Addresses

Primary practice location

4864 Santa Monica Blvd
Los Angeles, CA 90029-2634

Mailing address

4864 Santa Monica Blvd
Los Angeles, CA 90029-2634
Phone (323) 661-2700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180119002460 CA Part B Supplier - Clinic/Group Practice 2264791250 Receives reassigned benefits from 2 practitioners
Practice locations: Pacoima, CA; Los Angeles, CA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2154204Holy Cross Urgent Care Inc4864 Santa Monica Blvd, Los Angeles, CA 90029Certificate of waiverSep 6, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1510358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510358400000",
    "number": "1750894879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4864 SANTA MONICA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900292634",
            "telephone_number": "323-661-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4864 SANTA MONICA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900292634",
            "telephone_number": "323-661-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLY CROSS URGENT CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-11",
        "last_updated": "2017-11-11",
        "status": "A",
        "authorized_official_last_name": "CHULYAN",
        "authorized_official_first_name": "MANUK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-661-2700"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2017; 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.