Sevilla Medical Group Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A63670 Issued in CA

Legal business name

SEVILLA MEDICAL GROUP INC

Practice address

2813 N Broadway
Los Angeles, CA 90031-2611

Phone

(323) 342-9764

Fax

(323) 342-9656

NPI assigned

Jul 14, 2008

Last updated

May 26, 2010By 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

Tomas Sevilla, MDNPI 1922189125

Title

Owner

Phone

(323) 342-9764

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

Locations

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.

• Tomas A Sevilla, M.D.

  • Specialist
  • Los Angeles, CA
  • NPI 1922189125

  Internal Medicine

  Medicare reassignment NPD Authorized official
• Walter Del Pinal, PA

  • Medical Physician Assistant
  • Los Angeles, CA
  • NPI 1356451082
  NPD (past)

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274832000000",
    "number": "1871757302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31340",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310340",
            "telephone_number": "323-342-9764",
            "fax_number": "323-342-9656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2813 N BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312611",
            "telephone_number": "323-342-9764",
            "fax_number": "323-342-9656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEVILLA MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-14",
        "last_updated": "2010-05-26",
        "status": "A",
        "authorized_official_last_name": "SEVILLA",
        "authorized_official_first_name": "TOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-342-9764",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A63670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seung C Son DDS, Inc (Son Dental Group)
• Tyler Joseph Sevco
• Seven O One Medical Clinic, Inc
• Severance Optometric Center,Inc
• Diep Seversen, PHARMD
• Brett John Sevilla, M.D.
• Cecilia Sevilla, RN
• Louise Sevilla, LCSW
• Mary Rita Sevilla, MFT
• Ricardo S Sevilla

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; 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.