Uptimum Care Medical Group &Ipa Inc

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

23055 Issued in CA

Legal business name

UPTIMUM CARE MEDICAL GROUP &IPA INC

Practice address

15342 Hawthorne Blvd
Ste 102
Lawndale, CA 90260-2152

Phone

(310) 644-8400

NPI assigned

Jul 24, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Olukemi A Wallace, MDNPI 1609804350

Title

Director

Phone

(310) 644-8400

Specialties & licenses 7

Addresses

Tax ID family

Uptimum Care Medical Group Ipa Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Uptimum Medical Group and Ipa Inc

  • Non-Pharmacy Dispensing Site
  • Inglewood, CA
  • NPI 1285452771
  NPD tax ID

Practitioners 1

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

• Olukemi A Wallace, M.D.

  • Specialist
  • Inglewood, CA
  • NPI 1609804350
  NPD (past) Authorized official

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1780026328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 W MANCHESTER BLVD",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903052514",
            "telephone_number": "310-644-8400",
            "fax_number": "310-644-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15342 HAWTHORNE BLVD",
            "address_2": "STE 102",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902602152",
            "telephone_number": "310-644-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2220 W Manchester Blvd",
            "address_purpose": "LOCATION",
            "city": "Inglewood",
            "state": "CA",
            "postal_code": "903052514",
            "country_code": "US",
            "telephone_number": "310-644-8400",
            "fax_number": "310-644-8424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "UPTIMUM CARE MEDICAL GROUP &IPA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "OLUKEMI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "310-644-8400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": "A48240",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "23055",
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "23055",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "23055",
            "primary": true
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CA",
            "license": "23055",
            "primary": false
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "CA",
            "license": "23055",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": "23055",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Lawndale, CA
• Providers in Lawndale, CA by specialty
• Preferred Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.