NPIMap

Organization Active NPI

New Faith Transitional Living

  • Family Medicine Physician
  • Gardena, CA
National Provider Identifier
1760868418
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20AA5193 Issued in CA
Legal business name
NEW FAITH TRANSITIONAL LIVING
Practice address
2233 W Rosecrans Ave
Gardena, CA 90249-2905
Phone
(310) 436-7760
NPI assigned
Aug 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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

Authorized official

Name
Alice Blaci
Title
President
Phone
(310) 436-7760

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X 20AA5193 CA Primary
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X PA12545 CA

Addresses

Primary practice location

2233 W Rosecrans Ave
Gardena, CA 90249-2905

Mailing address

2233 W Rosecrans Ave
Gardena, CA 90249-2905
Phone (310) 436-7760

Other names 1

  • West Gardena Community Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
New Faith Transitional Living3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438732800000",
    "number": "1760868418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 W ROSECRANS AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902492905",
            "telephone_number": "310-436-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 W ROSECRANS AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902492905",
            "telephone_number": "310-436-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW FAITH TRANSITIONAL LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-05",
        "last_updated": "2015-08-05",
        "status": "A",
        "authorized_official_last_name": "BLACI",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-436-7760"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20AA5193",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA12545",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Gardena Community Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gardena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; 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.