Immanuel Medical Center Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

IMMANUEL MEDICAL CENTER INC

Practice address

903 Crenshaw Blvd Ste 302
Los Angeles, CA 90019-1967

Phone

(323) 931-8866

NPI assigned

Jul 24, 2007

Last updated

Jul 24, 2007By 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

Clyde Arnold

Title

President

Phone

(323) 931-8866

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185235200000",
    "number": "1912107202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 CRENSHAW BLVD STE 302",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900191967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 CRENSHAW BLVD STE 302",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900191967",
            "telephone_number": "323-931-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMANUEL MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-07-24",
        "status": "A",
        "authorized_official_last_name": "ARNOLD",
        "authorized_official_first_name": "CLYDE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-931-8866"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Jul 24, 2007; 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.