SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP


Address: 4580 Electronics Pl, Los Angeles, CA 90039-1008
Phone: 8185025940

SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP (NPI# 1346328853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1346328853
Entity Type Organization
Organization Name SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
Practice Address 4580 Electronics Pl
Los Angeles
CA 90039-1008
Mailing Address 393 E Walnut St
3rd Fl Phr Group & Provider Enrollment
Pasadena
CA 91188-0001
Practice Telephone 8185025940
Mailing Telephone 6264057914
Mailing Fax Number 6264054600
Enumeration Date 2006-11-01
Last Update Date 2012-02-01
Authorized Official Name EDWARD M ELLISON JR. (EXECUTIVE MEDICAL DIRECTOR)
Authorized Official Telephone 6264057914
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 291U00000X Clinical Medical Laboratory Laboratories

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1982863783 Southern California Permanente Medical Group Health Maintenance Organization 43112 N 15th St, Lancaster, CA 93534-6219 2008-06-06
1275756652 Southern California Permanente Medical Group Health Maintenance Organization 2103 E Gonzales Rd, Oxnard, CA 93036-3757 2007-04-11
1891873303 Southern California Permanente Medical Group Clinical Medical Laboratory 11668 Sherman Way, N Hollywood, CA 91605-5831 2006-11-01
1861424376 Southern California Permanente Medical Group Health Maintenance Organization 3733 San Dimas St, Bakersfield, CA 93301-1407 2006-07-07
1316572753 Southern California Permanente Medical Group Health Maintenance Organization 9100 Rosedale Hwy, Bakersfield, CA 93312-2143 2020-03-05
1821635079 Southern California Permanente Medical Group Health Maintenance Organization 3471 W Century Blvd, Inglewood, CA 90303-1218 2019-12-06
1316409410 Southern California Permanente Medical Group Health Maintenance Organization 19105 Golden Valley Rd, Santa Clarita, CA 91387-1428 2019-04-05
1942787114 Southern California Permanente Medical Group Health Maintenance Organization 3600 Rosemead Blvd, Rosemead, CA 91770-2066 2018-07-20
1164914115 Southern California Permanente Medical Group Health Maintenance Organization 2700 W 120th St, Hawthorne, CA 90250-3388 2018-06-05
1013409036 Southern California Permanente Medical Group Health Maintenance Organization 8999 Balboa Blvd, Northridge, CA 91325-2608 2018-06-05

Office Location

Street Address 4580 ELECTRONICS PL
City LOS ANGELES
State CA
Zip Code 90039-1008

Providers in the same location

NPI Name Taxonomy Address Enumeration
1326027285 Kimberly Anne Wendt Genetic Counselor, MS 4580 Electronics Pl, Scpmg Genetic Testing, Los Angeles, CA 90039-1008 2006-01-10
1639780075 Annina Cooper Genetic Counselor, MS 4580 Electronics Pl, Los Angeles, CA 90039-1008 2020-08-10
1124269717 Southern California Permanente Medical Group Eyewear Supplier (Equipment, not the service) 4580 Electronics Pl, Los Angeles, CA 90039-1008 2009-03-12
1154506939 Ruan T Ramjit Pathology 4580 Electronics Pl, Los Angeles, CA 90039-1008 2007-12-30

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1891298642 Shlomit Yelin-arber Marriage & Family Therapist 3401 Glendale Blvd Rm 2, Los Angeles, CA 90039 2018-03-16
1306385646 Robert Dao Pharmacist 11115 S Main St, Los Angeles, Ca, Los Angeles, CA 90039 2017-02-20
1528437951 Marcos Farias Licensed Vocational Nurse 3108 Hollydale Drive Apt 102, Los Angeles, CA 90039 2015-09-16
1578962312 Alexandria Trubatisky Nurse Practitioner 3026 Casitas Ave, Los Angeles, CA 90039 2014-08-18
1780003350 Amanda Cohen Acupuncturist 3036 Glendale Blvd., Los Angeles, CA 90039 2014-04-10
1710231568 Alan Russell Hedman Counselor 3352 Larga Ave, Los Angeles, CA 90039 2012-11-01
1427317486 Christopher Peabody Emergency Medicine 1200 North State Street Room 1011, Los Angeles, CA 90039 2012-05-11
1447529359 Janein Chavez Marriage & Family Therapist 3111 Los Feliz Blvd Ste 205, Los Angeles, CA 90039 2011-12-21
1265727358 Erzsebet Olah Licensed Vocational Nurse 2586 Lake-view Ave, Los Angeles, CA 90039 2011-06-16
1750691168 Sharon Furman Specialist 3147 Glenmanor Place, 145d, Los Angeles, CA 90039 2010-10-19
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Taxonomy Information

Taxonomy Code 291U00000X
Grouping Laboratories
Classification Clinical Medical Laboratory

Taxonomy Definition

(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1518565514 Clarity Mobile Venture LLC Clinical Medical Laboratory 651 World Way, Los Angeles, CA 90045-5815 2020-10-12
1134748312 Steaman Laboratory Incorporated Clinical Medical Laboratory 3631 Crenshaw Blvd Ste 103, Los Angeles, CA 90016-4869 2020-04-08
1528619970 Community Laboratory Inc Clinical Medical Laboratory 1919 W 7th St Unit L, Los Angeles, CA 90057-4103 2019-09-26
1982173423 Sequence46, LLC Clinical Medical Laboratory 5777 W Century Blvd Ste 540, Los Angeles, CA 90045-5688 2018-11-14
1699271502 Medbetter Health Solutions, LLC Clinical Medical Laboratory 11669 Rochester Ave Apt 101, Los Angeles, CA 90025-2381 2018-04-02
1144769068 Flow Health Laboratories LLC Clinical Medical Laboratory 8885 Venice Blvd Ste 104, Los Angeles, CA 90034-3242 2017-02-13
1699226415 Kathleen Ann Kelly Clinical Medical Laboratory David Geffen Medical Ctr Ucla 10833 Le Conte Ave, Mailroom A3-215 Chs, Mailcode 173216, Los Angeles, CA 90095-1732 2016-10-17
1306203229 Quick and Easy Hplebotomy Services, LLC Clinical Medical Laboratory 9029 Airport Blvd Unit 91896, Los Angeles, CA 90009-4904 2016-01-22
1992161632 Pachulski Industries Inc Clinical Medical Laboratory 100 Copa De Oro Rd, Los Angeles, CA 90077-3802 2016-01-11
1851761282 Dynamic Clinical Laboratories, Inc. Clinical Medical Laboratory 516 N Larchmont Blvd, Los Angeles, CA 90004-1306 2015-09-28
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Competitor

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City LOS ANGELES
Zip Code 90039

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Dataset Information

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.

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