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LA COMMUNITY CARE MEDICAL NPI 1801099486


NPI Information

NPI: 1801099486
Provider Name: LA COMMUNITY CARE MEDICAL

Other Name: LA COMMUNITY CARE MEDICAL ASSOCIATES INC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D0937821

Address:
11633 HAWTHORNE BLVD STE 103
HAWTHORNE, CA
ZIP 90250
Phone: (310) 219-2929
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LA COMMUNITY CARE MEDICAL is a family medicine in Hawthorne, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LA COMMUNITY CARE MEDICAL NPI is 1801099486. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is La Community Care Medical Associates Inc.

The provider's business location address is:

11633 HAWTHORNE BLVD STE 103
HAWTHORNE, CA
ZIP 90250-323
Phone: (310) 219-2929
Fax: (310) 219-2940

The provider's authorized official is Augustine Iluore .
The authorized official title is Medical Director and has the following contact phone number (310) 219-2929.

The CLIA number assigned to this NPI record is 05D0937821 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 6/8/2007 and was last updated on 4/14/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineA053317CALIFORNIANo
2207Q00000XFamily MedicineA053317CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1W14047MEDICARE ID-TYPE UNSPECIFIEDMEDICARE PROVIDER NUMBER
2GR0081270MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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