Loyola Family Health Center Professional Corporation

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

LOYOLA FAMILY HEALTH CENTER PROFESSIONAL CORPORATION

Practice address

4225 Tweedy Blvd
South Gate, CA 90280-6217

Phone

(323) 564-6464

Fax

(323) 564-8578

NPI assigned

Feb 6, 2019

Organization subpart

No

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

Authorized official

Name

Alejandro Lazaro Gonzalez, DONPI 1538108097

Title

Owner

Phone

(626) 664-1279

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 2

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

• Alejandro Lazaro Gonzalez

  • General Practice Physician
  • South Gate, CA
  • NPI 1538108097
  Medicare reassignment Authorized official
• Brittany Denise Anghel, PA-C

  • Medical Physician Assistant
  • Plainfield, NJ
  • NPI 1003499575

  CA

  Medicare reassignment

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1760947451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 TWEEDY BLVD STE B",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806217",
            "telephone_number": "323-564-6464",
            "fax_number": "323-564-8578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 TWEEDY BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806217",
            "telephone_number": "323-564-6464",
            "fax_number": "323-564-8578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOYOLA FAMILY HEALTH CENTER PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-06",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ALEJANDRO",
        "authorized_official_middle_name": "LAZARO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-664-1279",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Loyola Medical Center a Professional Corporation
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• Luis Moran DDS a Dental Corporation
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• Lulu L. Chen, MD Inc.

• General Practice Physician in South Gate, CA
• Providers in South Gate, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.