ST. JOHNS URGENT CARE & MEDICAL CORPORATION (NPI# 1023524980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023524980 |
| Entity Type | Organization |
| Organization Name | ST. JOHNS URGENT CARE & MEDICAL CORPORATION |
| Other Organization Name | NONE |
| Practice Address |
1138 N Western Ave Los Angeles CA 90029-1702 |
| Mailing Address |
1138 North Western Ave Los Angeles CA 90029-1702 |
| Practice Telephone | 3239579300 |
| Practice Fax Number | 3239579315 |
| Mailing Telephone | 3239579300 |
| Mailing Fax Number | 3239579315 |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2017-12-20 |
| Authorized Official Name | MIKE MANSOUR ROSTAMI (MEDICAL DIRECTOR/ OWNER) |
| Authorized Official Telephone | 3239579300 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | Y |
| Parent Organization Name | ST .JOHN URGENT CARE & MEDICAL CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | A50108 | CA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| none | Former Legal Business Name - Organization |
| Street Address |
1138 N WESTERN AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90029-1702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053884775 | Melrose Recovery, LLC. | Substance Abuse Rehabilitation Facility | 1253 N Commonwealth Ave, Los Angeles, CA 90029 | 2019-01-04 |
| 1548740939 | Mission City Community Network Inc | Clinic/Center | 5300 Santa Monica Blvd Ste 202, Los Angeles, CA 90029 | 2018-08-15 |
| 1215454707 | Dennis De Vera | Respiratory Therapist, Registered | 1154 N. Berendo St, Los Angeles, CA 90029 | 2017-08-24 |
| 1508390881 | Acadia Malibu, Inc. | Community/Behavioral Health | 4423 and 4423 1/2 Santa Monica Boulevard, Los Angeles, CA 90029 | 2017-04-13 |
| 1023556610 | Jasen Mcgoldrick | Substance Abuse Rehabilitation Facility | 4445 Burns Ave., Los Angeles, CA 90029 | 2017-02-03 |
| 1679930572 | Sukhwa Park | Acupuncturist | 4870 Santa Monica Blvd, Los Angeles, CA 90029 | 2016-01-22 |
| 1629326749 | Jocelyn Anne Brown | Midwife | 1042 Sanborn Ave Apt 9, Los Angeles, CA 90029 | 2012-08-21 |
| 1811211915 | Advanced Skilled Nursing Inc. | Skilled Nursing Facility | 975 North Virgil Avenue, Los Angeles, CA 90029 | 2010-03-17 |
| 1427244060 | Manuel Masaganda Ferreras | Technician/Technologist | 1131 N Vermont Ave Ste 101, Los Angeles, CA 90029 | 2007-09-18 |
| 1033321013 | Zhirayr Jerry Khoshoryan | Chiropractor | 1233 Vermont Ave., Suite 1b, Los Angeles, CA 90029 | 2007-05-04 |
| Find all providers in zip 90029 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1104470384 | Chan Family Medical Corp | General Practice | 4070 E. Olympic Blvd, Los Angeles, CA 90023 | 2019-07-26 |
| 1972064004 | Divine Help Medical Group Inc | General Practice | 1711 W Temple St Unit 5613, Los Angeles, CA 90026-5421 | 2019-03-29 |
| 1942767801 | Plaza Health Services Inc. | General Practice | 11111 Santa Monica Blvd Ste 200, Los Angeles, CA 90025-3333 | 2019-02-27 |
| 1124536289 | Edward Meltser | General Practice | 469 N Alfred St, Los Angeles, CA 90048-2504 | 2018-01-11 |
| 1992234199 | David Ghods | General Practice | 3631 Crenshaw Blvd Ste 109, Los Angeles, CA 90016-4869 | 2017-06-09 |
| 1740718345 | Cosmetic Laser Medspa, Inc. | General Practice | 1535 S La Cienega Blvd, Los Angeles, CA 90035-3714 | 2017-05-25 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90029 |
Please comment or provide details below to improve the information on ST. JOHNS URGENT CARE & MEDICAL CORPORATION.
| 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.