NPIMap

Organization Active NPI

San Antonio Inglewood Medical Clinic Inc

  • Clinic/Center
  • Lennox, CA
National Provider Identifier
1992970016
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
GO59290 Issued in CA
Legal business name
SAN ANTONIO INGLEWOOD MEDICAL CLINIC INC
Practice address
10811 S Grevillea Ave
Lennox, CA 90304-2325
Phone
(310) 673-1922
Fax
(310) 673-7701
NPI assigned
Apr 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Authorized official

Name
Thomas Gerke, M.D
Title
Director
Phone
(310) 673-1922

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X GO59290 CA Primary

Addresses

Primary practice location

10811 S Grevillea Ave
Lennox, CA 90304-2325

Mailing address

10811 S Grevillea Ave
Lennox, CA 90304-2325
Phone (310) 673-1922

National Provider Directory

National Provider Directory

Locations

10811 S Grevillea Ave
Inglewood, CA 90304
Phone (310) 673-1922

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": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1992970016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10811 S GREVILLEA AVE",
            "city": "LENNOX",
            "state": "CA",
            "postal_code": "903042325",
            "telephone_number": "310-673-1922",
            "fax_number": "310-673-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10811 S GREVILLEA AVE",
            "city": "LENNOX",
            "state": "CA",
            "postal_code": "903042325",
            "telephone_number": "310-673-1922",
            "fax_number": "310-673-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO INGLEWOOD MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "GERKE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "310-673-1922",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "GO59290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lennox, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.