St Andrews Medical Group Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

A40329 Issued in CA

Legal business name

ST ANDREWS MEDICAL GROUP INC

Practice address

5520 Santa Monica Blvd
Suite 112
Los Angeles, CA 90038-2932

Phone

(323) 860-9054

NPI assigned

Jan 22, 2007

Last updated

Aug 22, 2020By 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

Dr. Arthur Valles, MD

Title

Physician

Phone

(323) 860-9054

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821142670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 SANTA MONICA BLVD",
            "address_2": "SUITE 112",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900382932",
            "telephone_number": "323-860-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 SANTA MONICA BLVD",
            "address_2": "SUITE 112",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900382932",
            "telephone_number": "323-860-9054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ANDREWS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VALLES",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "323-860-9054",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A40329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A40329",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.