NPIMap

Organization Active NPI

Healthy Longevity Medical Center

Doing business as infinity Summer Services

  • Clinic/Center
  • Carson, CA
National Provider Identifier
1912690132
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
HEALTHY LONGEVITY MEDICAL CENTER
Doing business as
Healthy longevity Medical Center
infinity Summer Services
Practice address
441 E Carson St Ste K
Carson, CA 90745-7713
Phone
(949) 413-1955
NPI assigned
Jun 1, 2023
Last updated
Jun 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miss Aida Souleiman, NPNPI 1205427150
Title
Owner
Phone
(949) 413-1955

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

441 E Carson St Ste K
Carson, CA 90745-7713

Mailing address

552 E Carson St Apt 409
Carson, CA 90745-2890

Other names 2

  • Healthy longevity Medical Center Doing business as
  • infinity Summer Services Doing business as

National Provider Directory

National Provider Directory

Locations

441 E Carson St
Ste K
Carson, CA 90745
Phone (732) 375-0420

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1912690132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "552 E CARSON ST APT 409",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907452890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 E CARSON ST STE K",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907457713",
            "telephone_number": "949-413-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LONGEVITY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-01",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "SOULEIMAN",
        "authorized_official_first_name": "AIDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-413-1955",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy longevity Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "infinity Summer Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.