Organization Active NPI

Fatima Medical Center Inc

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1912438516
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
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

Updated by the provider on Mar 24, 2017

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

NPI 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.

Verify at the official NPI Registry.