Integrated Healthcare Medical Group Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A38857 Issued in CA

Legal business name

INTEGRATED HEALTHCARE MEDICAL GROUP INC.

Practice address

1762 Westwood Blvd Ste 300
Los Angeles, CA 90024-5641

Phone

(310) 441-2000

Fax

(310) 441-2020

NPI assigned

Aug 5, 2006

Last updated

Aug 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ifrain Contreras

Title

Administrator

Phone

(310) 419-4303

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722902400000",
    "number": "1801805056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1762 WESTWOOD BLVD STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245641",
            "telephone_number": "310-441-2000",
            "fax_number": "310-441-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1762 WESTWOOD BLVD STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245641",
            "telephone_number": "310-441-2000",
            "fax_number": "310-441-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2850 Artesia Blvd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Redondo Beach",
            "state": "CA",
            "postal_code": "902783412",
            "country_code": "US",
            "telephone_number": "310-419-4303",
            "fax_number": "310-214-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTEGRATED HEALTHCARE MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "CONTRERAS",
        "authorized_official_first_name": "IFRAIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "310-419-4303",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A38857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0085621",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0085620",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.