INTEGRATIVE MEDICAL GROUP, INC (NPI# 1003369380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003369380 |
| Entity Type | Organization |
| Organization Name | INTEGRATIVE MEDICAL GROUP, INC |
| Practice Address |
2200 W 3rd St Suite 120 A Los Angeles CA 90057-1932 |
| Practice Telephone | 3109053331 |
| Practice Fax Number | 3104532916 |
| Mailing Telephone | 3109053331 |
| Mailing Fax Number | 3104532916 |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2016-08-03 |
| Authorized Official Name | RYAN M SPIVAK (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 3109053331 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
A113632 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
2200 W 3RD ST SUITE 120 A |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90057-1932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023090784 | Taro Yokoyama | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2200 W 3rd St, Suite 300, Los Angeles, CA 90057-1932 | 2005-11-17 |
| 1841659042 | Ryan Spivak Integrative Plastic Surgery Inc | Surgery | 2200 W 3rd St, Suite 120a, Los Angeles, CA 90057-1932 | 2016-02-16 |
| 1669749149 | Robert Naraghi, Md Inc | Transplant Surgery | 2200 W 3rd St, Ste 500, Los Angeles, CA 90057-1932 | 2011-11-28 |
| 1023287372 | Mi Mi Chang | Nurse Practitioner | 2200 W 3rd St, Suite 500, Los Angeles, CA 90057-1932 | 2008-02-20 |
| 1346420551 | Harlan C Amstutz Md Inc | Orthopaedic Surgery | 2200 W 3rd St, Ste. 400, Los Angeles, CA 90057-1932 | 2007-11-06 |
| 1841479839 | Carlos Vasquez | Physician Assistant | 2200 W 3rd St, #400, Los Angeles, CA 90057-1932 | 2007-10-26 |
| 1306025481 | Thomas P Schmalzried M D A Professional Corporation | Orthopaedic Surgery | 2200 W 3rd St, Ste 400, Los Angeles, CA 90057-1932 | 2007-10-25 |
| 1346434529 | Farid Moshirbahram | Physician Assistant | 2200 W 3rd St, #120, Los Angeles, CA 90057-1932 | 2007-08-30 |
| 1164628863 | St. Vincent Medical Center | General Acute Care Hospital | 2200 W 3rd St, Suite #500, Los Angeles, CA 90057-1932 | 2007-06-21 |
| 1669502894 | Lytton Williams, M.d., PC | Orthopaedic Surgery | 2200 W 3rd St, Suite 120, Los Angeles, CA 90057-1932 | 2007-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518315 | Mayulee Wilawanwelsh | Massage Therapist | 349 S Lafayette Pk Pl, Los Angeles, CA 90057 | 2020-11-03 |
| 1437714615 | Jackeline L Ramon | Social Worker | 572 S. La Fayette Park Place #6, Los Angeles, CA 90057 | 2019-05-03 |
| 1467015743 | Chanhwi Jung | Acupuncturist | 349 South Lafayette Park Place, #208, Los Angeles, CA 90057 | 2019-04-22 |
| 1356818850 | Anshim Acupuncture Inc | Acupuncturist | 4501 Alameda St., #107b #115, Los Angeles, CA 90057 | 2018-11-01 |
| 1538634670 | Karina Herrera | Case Manager/Care Coordinator | 679 S. Hampshire Ave, Los Angeles, CA 90057 | 2018-10-04 |
| 1306323506 | Jessica Myung Jin Yun | Counselor | 520 S Lafayette Park Pl, Unit 300, Los Angeles, CA 90057 | 2018-07-20 |
| 1851887012 | Scott Moon | Dentist | 2426 W. 8th St. #209, Los Angeles, CA 90057 | 2018-07-10 |
| 1780176107 | Bianca Zafiro | Case Manager/Care Coordinator | 672 S Lafayette Park Place, Suite 6, Los Angeles, CA 90057 | 2018-06-01 |
| 1639677438 | Claudia E Vides Inc A Dental Corporation | Clinic/Center | 2033 W. 7th Street, Los Angeles, CA 90057 | 2018-01-26 |
| 1720596414 | Hee Sun No | Pharmacist | 269 S Lafayette Park Pl, 210, Los Angeles, CA 90057 | 2018-01-16 |
| Find all providers in zip 90057 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447560289 | Tadeusz Wellisz | Surgery | 536 South Rimpau Blvd, Los Angeles, CA 90020 | 2010-10-14 |
| 1801971478 | Kyoung Chol Kim | Surgery | 2970 W Olympic Blvd, Suite 204 & 205, Los Angeles, CA 90006-2518 | 2006-10-25 |
| 1770006538 | Debra Ann Wallace | Surgery | 1100 N State Street, Clinic Tower A6a231a, Los Angeles, CA 90033 | 2017-07-24 |
| 1841659042 | Ryan Spivak Integrative Plastic Surgery Inc | Surgery | 2200 W 3rd St, Suite 120a, Los Angeles, CA 90057-1932 | 2016-02-16 |
| 1548659170 | Libby Wilson Md Inc | Surgery | 403 W Adams Blvd, Los Angeles, CA 90007-2664 | 2015-01-20 |
| 1811330566 | Ginger C Slack | Surgery | 200 Ucla Medical Plz Ste 460, Los Angeles, CA 90095-5224 | 2013-04-12 |
| 1265705925 | Gary Motykie, M.d. A Medical Corporation | Surgery | 9201 W Sunset Blvd, Suite Gf-1, Los Angeles, CA 90069-3701 | 2012-02-10 |
| 1851607642 | Mark L Labowe M D A Prof Corp | Surgery | 12301 Wilshire Blvd, Suite 325, Los Angeles, CA 90025-1007 | 2010-08-31 |
| 1699003731 | Jeffrey D Hoefflin Md Inc | Surgery | 9201 W Sunset Blvd, Ste.#805, Los Angeles, CA 90069-3701 | 2009-12-01 |
| 1255579272 | Anita Patel, M.d., Inc. | Surgery | 1245 Wilshire Blvd, Suite 601, Los Angeles, CA 90017-4810 | 2009-01-29 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90057 |
Please comment or provide details below to improve the information on INTEGRATIVE MEDICAL GROUP, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.