South Central Medical Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SOUTH CENTRAL MEDICAL CLINIC

Practice address

10024 S Vermont Ave
Los Angeles, CA 90044-3112

Phone

(323) 756-1412

Fax

(323) 756-1413

NPI assigned

Oct 25, 2020

Last updated

Oct 25, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Quinta Cunningham

Title

Authorize Official

Phone

(323) 756-1412

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1603584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603584000000",
    "number": "1962001420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10024 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900443112",
            "telephone_number": "323-756-1412",
            "fax_number": "323-756-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10024 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900443112",
            "telephone_number": "323-756-1412",
            "fax_number": "323-756-1413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-25",
        "last_updated": "2020-10-25",
        "certification_date": "2020-10-25",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "QUINTA",
        "authorized_official_title_or_position": "AUTHORIZE OFFICIAL",
        "authorized_official_telephone_number": "323-756-1412"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Central Family Health Center (Wellness Center at Jefferson High School)
• South Central Family Health Center
• South Central Family Health Center
• South Central Family Health Center (SCFHC - Mobile Unit)
• South Central Los Angeles Regional Center for Developmentally Disabled
• South Central Residential Care #2
• South Coast Diagnostic Medical Group
• South Fork Healthcare, LLC (Dba Serrano South Conv Hospital)
• South Healthcare Center LLC (Country Villa South Healthcare Center)
• South la Eye Clinic

• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2020; 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.