ST. JOHNS URGENT CARE & MEDICAL CORPORATION NPI 1023524980

NPI Information

ST. JOHNS URGENT CARE & MEDICAL CORPORATION is a general practice in Los Angeles, CA. ST. JOHNS URGENT CARE & MEDICAL CORPORATION NPI is 1023524980. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is None.

The provider's business location address is:

1138 N WESTERN AVE
LOS ANGELES, CA
ZIP 90029-702
Phone: (323) 957-9300
Fax: (323) 957-9315

The provider's authorized official is Mike Mansour Rostami .
The authorized official title is MEDICAL DIRECTOR/ OWNEROwner and has the following contact phone number (323) 957-9300.

The CLIA number assigned to this NPI record is 05D0975886 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/14/2017 and was last updated on 12/20/2017.

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:

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