NPIMap

Organization Active NPI

Icm Medical Group Inc

  • Clinic Pharmacy
  • Inglewood, CA
National Provider Identifier
1922461300
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
ICM MEDICAL GROUP INC
Practice address
211 N Prairie Ave
Inglewood, CA 90301-1412
Phone
(310) 855-0556
Fax
(310) 419-9475
NPI assigned
Apr 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Authorized official

Name
Amanuel Sima, MDNPI 1366493744
Title
President
Phone
(310) 855-0556

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X Primary

Addresses

Primary practice location

211 N Prairie Ave
Inglewood, CA 90301-1412

Mailing address

PO Box 1698
Inglewood, CA 90308-1698
Phone (310) 855-0556

National Provider Directory

National Provider Directory
Tax ID family
Icm Medical Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459468800000",
    "number": "1922461300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1698",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903081698",
            "telephone_number": "310-855-0556",
            "fax_number": "310-419-9475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N PRAIRIE AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011412",
            "telephone_number": "310-855-0556",
            "fax_number": "310-419-9475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICM MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-01",
        "last_updated": "2016-04-01",
        "status": "A",
        "authorized_official_last_name": "SIMA",
        "authorized_official_first_name": "AMANUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-855-0556",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; 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.