Active NPI
Fatima Medical Center Inc
- Family Medicine Physician
- Los Angeles, CA
National Provider Identifier
1912438516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- FATIMA MEDICAL CENTER INC
- Practice address
- 3700 Wilshire Blvd
Suite 422
Los Angeles, CA 90010-2901 - Phone
- (310) 674-1754
- NPI assigned
- Mar 24, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jacob Edem
- Title
- Administrator
- Phone
- (213) 718-0970
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
3700 Wilshire Blvd
Suite 422
Los Angeles, CA 90010-2901
Mailing address
4508 W Imperial Hwy
Inglewood, CA 90304-2710
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490313600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1490313600000",
"number": "1912438516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4508 W IMPERIAL HWY",
"city": "INGLEWOOD",
"state": "CA",
"postal_code": "903042710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 WILSHIRE BLVD",
"address_2": "SUITE 422",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900102901",
"telephone_number": "310-674-1754"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FATIMA MEDICAL CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2017-03-24",
"last_updated": "2017-03-24",
"status": "A",
"authorized_official_last_name": "EDEM",
"authorized_official_first_name": "JACOB",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "213-718-0970"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.