NPIMap

Organization Active NPI

County of Los Angeles

Doing business as Martin Luther King, Jr. Outpatient Center

  • Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1780877613
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
COUNTY OF LOS ANGELES
Doing business as
Martin Luther King, Jr. Outpatient Center
Practice address
1670 E 120TH St
Los Angeles, CA 90059-3026
Phone
(310) 668-5201
NPI assigned
Aug 23, 2007
Last updated
May 14, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTY OF LOS ANGELESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Authorized official

Name
Ms. Cynthia Oliver
Title
Administrator
Phone
(424) 338-1001

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Ambulatory Surgical Clinic/Center 261QA1903X

Addresses

Primary practice location

1670 E 120TH St
Los Angeles, CA 90059-3026

Mailing address

1670 E 120TH St
Los Angeles, CA 90059-3026
Phone (310) 668-5201

Other names 1

  • Martin Luther King, Jr. Outpatient Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031204001218 CA Part B Supplier - Clinic/Group Practice 1850296534 Receives reassigned benefits from 1,953 practitioners
49 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Los Angeles, CA; Pacoima, CA; Monrovia, CA; North Hollywood, CA; Palmdale, CA; Pomona, CA; San Fernando, CA; Santa Monica, CA…
O20090713000358 CA Part B Supplier - Ambulatory Surgical Center 1850296534 Receives reassigned benefits from 437 practitioners
1 other NPI on this enrollment
Practice locations: Lancaster, CA; Los Angeles, CA

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 49

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 49

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Martin Luther King Jr Ambulatory Surgical CenterCCN 05C0001880
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Part of
Public Health Pharmacy

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rancho Los Amigos National Rehabilitation CenterDowney, CA, CCN 050717 Hospital Other Jul 9, 2013
County of Los Angeles Olive View UCLA Medical CenterSylmar, CA, CCN 050040 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 25, 1986
Los Angeles General Medical CenterLos Angeles, CA, CCN 050373 Hospital Operational/Managerial Control (5%) Jul 1, 1984
Los Angeles General Medical CenterLos Angeles, CA, CCN 05S373 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 12, 2010
County of Los AngelesDowney, CA, CCN 05T717 Hospital Other Jul 9, 2013
County of Los Angeles-Olive View-UCLA Medical CenterSylmar, CA, CCN 05S040 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 12, 2010

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 484

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.

View all 484

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1780877613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 E 120TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593026",
            "telephone_number": "310-668-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 E 120TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593026",
            "telephone_number": "310-668-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF LOS ANGELES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF LOS ANGELES",
        "enumeration_date": "2007-08-23",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "424-338-1001",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Martin Luther King, Jr. Outpatient Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Martin Luther King, Jr. Outpatient Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.