NPIMap

Organization Active NPI

Southern California Immediate Medical Center

  • Family Medicine Physician
  • Lakewood, CA
National Provider Identifier
1811042351
Registry record updated Mar 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOUTHERN CALIFORNIA IMMEDIATE MEDICAL CENTER
Practice address
5203 Lakewood Blvd
Lakewood, CA 90712-2415
Phone
(562) 633-2273
Fax
(562) 633-1796
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2009

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

Authorized official

Name
Thomas Roccapalumbo, D.O.
Title
Medical Director
Phone
(323) 726-3212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5203 Lakewood Blvd
Lakewood, CA 90712-2415

Mailing address

7300 Alondra Blvd Ste 101
Paramount, CA 90723-4000
Phone (562) 531-8300

National Provider Directory

National Provider Directory
Tax ID family
Southern California Immediate Medical Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236816000000",
    "number": "1811042351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 ALONDRA BLVD STE 101",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907234000",
            "telephone_number": "562-531-8300",
            "fax_number": "562-531-8035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5203 LAKEWOOD BLVD",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907122415",
            "telephone_number": "562-633-2273",
            "fax_number": "562-633-1796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA IMMEDIATE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2009-03-12",
        "status": "A",
        "authorized_official_last_name": "ROCCAPALUMBO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "323-726-3212",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; 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.