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HIGH DESERT WOMENS MEMORIAL MEDICAL CENTER APC NPI 1033304894


NPI Information

NPI: 1033304894
Provider Name: HIGH DESERT WOMENS MEMORIAL MEDICAL CENTER APC

Doing Business As: CLINICA SANTA MARIA ECHO PARK

Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 05D1050936

Address:
625 W COLLEGE ST STE 105
LOS ANGELES, CA
ZIP 90012
Phone: (213) 265-7433
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HIGH DESERT WOMENS MEMORIAL MEDICAL CENTER APC is a specialist in Los Angeles, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. HIGH DESERT WOMENS MEMORIAL MEDICAL CENTER APC NPI is 1033304894. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Clinica Santa Maria Echo Park.

The provider's business location address is:

625 W COLLEGE ST STE 105
LOS ANGELES, CA
ZIP 90012-650
Phone: (213) 265-7433
Fax: (213) 265-7531

The provider's authorized official is Lu-wei King .
The authorized official title is Medical Director and has the following contact phone number (213) 482-4400.

The CLIA number assigned to this NPI record is 05D1050936 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/13/2007 and was last updated on 7/4/2023.


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
1174400000XSpecialistA50695CALIFORNIAYes

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
11033304894MEDICAIDCALIFORNIA
2DM453AOTHERCALIFORNIAMEDICARE PTAN

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.