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INDIANA FIRST MEDICAL GROUP INC NPI 1063591584


NPI Information

NPI: 1063591584
Provider Name: INDIANA FIRST MEDICAL GROUP INC

Doing Business As: INDIANA FIRST MEDICAL GROUP

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D0545439

Address:
4082 WHITTIER BLVD STE 103
LOS ANGELES, CA
ZIP 90023
Phone: (323) 268-5598
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INDIANA FIRST MEDICAL GROUP INC is a family medicine in Los Angeles, 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. INDIANA FIRST MEDICAL GROUP INC NPI is 1063591584. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Indiana First Medical Group.

The provider's business location address is:

4082 WHITTIER BLVD STE 103
LOS ANGELES, CA
ZIP 90023-559
Phone: (323) 268-5598
Fax: (323) 268-8892

The provider's authorized official is Pei Hsin Chao .
The authorized official title is Owner and has the following contact phone number (323) 268-5598.

The CLIA number assigned to this NPI record is 05D0545439 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/3/2006 and was last updated on 6/3/2021.


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
1207Q00000XFamily MedicineA048560CALIFORNIAYes

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
1ZZZ81352ZMEDICAIDCALIFORNIA

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

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.