Mitla Professional Nursing Care, Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MITLA PROFESSIONAL NURSING CARE, INC

Practice address

4111 Maine Ave
Baldwin Park, CA 91706-3307

Phone

(626) 939-0676

Fax

(626) 517-5482

NPI assigned

Feb 5, 2024

Last updated

May 22, 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

Antonio Martinez, NPNPI 1528236981

Title

Ceo

Phone

(323) 369-0955

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

Practitioners 2

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.

• Antonio Martinez

  • Family Nurse Practitioner
  • Los Angeles, CA
  • NPI 1528236981
  Medicare reassignment NPD Authorized official
• Eluar Mendez Hernandez

  • Family Medicine Physician
  • Estero, FL
  • NPI 1487233946

  CA

  Medicare reassignment

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1811750425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 MAINE AVE",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 MAINE AVE",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063307",
            "telephone_number": "626-939-0676",
            "fax_number": "626-517-5482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITLA PROFESSIONAL NURSING CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-369-0955",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zin Min, O.D.
• Minabil Inc. (Vitamedex)
• Milagros P. Minaya, MD
• Natasha Mironov, CNM
• Michael L. Mitchell, MD
• Richard S. Mittleman, MD
• MJS Designs (Ramona Pharmacy)
• Hooman Mobassery, MD
• Bobeck S Modjtahedi, M.D.
• Katherine M Moeller, SP

• Clinic/Center in Baldwin Park, CA
• Providers in Baldwin Park, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.