NPIMap

Organization Active NPI

Santa Teresita Medical Clinic Group Inc

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1932425899
Registry record updated Apr 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A51248 Issued in CA
Legal business name
SANTA TERESITA MEDICAL CLINIC GROUP INC
Practice address
2929 N Broadway
Los Angeles, CA 90031-2602
Phone
(323) 222-5550
Fax
(323) 222-5552
NPI assigned
Apr 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2010

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

Authorized official

Name
Melvin Lewis, M. D
Title
Owner
Phone
(323) 222-5550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X A51248 CA Primary

Addresses

Primary practice location

2929 N Broadway
Los Angeles, CA 90031-2602

Mailing address

2929 N Broadway
Los Angeles, CA 90031-2602
Phone (323) 222-5550

Other names 1

  • Santa Teresita Medical Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

2929 N Broadway
Los Angeles, CA 90031
Phone (323) 222-5555

Practitioners & affiliated clinicians

Practitioners 5

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": "1271289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271289600000",
    "number": "1932425899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 N BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312602",
            "telephone_number": "323-222-5550",
            "fax_number": "323-222-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 N BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312602",
            "telephone_number": "323-222-5550",
            "fax_number": "323-222-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA TERESITA MEDICAL CLINIC GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-15",
        "last_updated": "2010-04-15",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-222-5550",
        "authorized_official_credential": "M. D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A51248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Santa Teresita Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 15, 2010; 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.