OMNICARE MEDICAL GROUP, INC (NPI# 1457548604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457548604 |
| Entity Type | Organization |
| Organization Name | OMNICARE MEDICAL GROUP, INC |
| Practice Address |
3680 E Imperial Hwy Suite 480 Lynwood CA 90262-2659 |
| Practice Telephone | 3106050000 |
| Practice Fax Number | 3106050051 |
| Mailing Telephone | 3106050000 |
| Mailing Fax Number | 3106050051 |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2007-10-02 |
| Authorized Official Name | TONI JOHNSON-CHAVIS (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 3106050000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | OMNICARE MEDICAL GROUP, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 302R00000X | Health Maintenance Organization | Managed Care Organizations |
| Street Address |
3680 E IMPERIAL HWY SUITE 480 |
| City | LYNWOOD |
| State | CA |
| Zip Code | 90262-2659 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104823814 | Ricardo Enrique Mckenzie | Internal Medicine | 3680 E Imperial Hwy, Suite 470, Lynwood, CA 90262-2659 | 2005-07-07 |
| 1326684697 | Charlene Alugbue | Counselor | 3680 E Imperial Hwy, Lynwood, CA 90262-2659 | 2019-11-21 |
| 1518450451 | Tyrone Ledford | Case Manager/Care Coordinator | 3680 E Imperial Hwy, Lynwood, CA 90262-2659 | 2018-06-13 |
| 1184130718 | Brisa Aidee Aguilar | Case Manager/Care Coordinator | 3680 E Imperial Hwy, Lynwood, CA 90262 | 2017-12-19 |
| 1588184022 | Tiffany Martinez | Case Manager/Care Coordinator | 3680 E Imperial Hwy, Lynwood, CA 90262-2659 | 2017-06-26 |
| 1942741798 | Western Dental Services, Inc. | Dentist | 3680 E Imperial Hwy, Suite 100, Lynwood, CA 90262-2659 | 2017-03-13 |
| 1033666565 | Fabby Badillo Contreras | Rehabilitation Practitioner | 3680 E Imperial Hwy, Suite 520, Lynwood, CA 90262 | 2016-09-01 |
| 1003267154 | Yvette Trujillo | Rehabilitation Practitioner | 3680 E Imperial Hwy, Lynwood, CA 90262-2659 | 2016-06-29 |
| 1407205420 | Kimberly Maldonado | Rehabilitation Practitioner | 3680 E Imperial Hwy, Lynwood, CA 90262-2659 | 2016-06-09 |
| 1699137893 | Mayra Lucas | Rehabilitation Practitioner | 3680 E Imperial Hwy, Lynwood, CA 90262-2659 | 2016-03-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811546062 | Sheila Maxine Wilkins | Technician | 3940 Palm Ave, Lynwood, CA 90262 | 2019-09-10 |
| 1891344669 | Chezoma Latissue Davis | Technician | 4255 Niland St, Lynwood, CA 90262 | 2019-09-05 |
| 1295223345 | Scla Comprehensive Surgical Medical Group, Inc. | Clinic/Center | 3628 E Imperial Hwy Ste 204, Lynwood, CA 90262 | 2018-04-24 |
| 1891213807 | Grecia Veronica Nunez | Case Manager/Care Coordinator | 3680 E. Imperial Highway, Suite 200, Lynwood, CA 90262 | 2017-08-30 |
| 1134643448 | Angelica Jazmin Alonso Cortes | Case Manager/Care Coordinator | 2610 Industry Way Suite A, Lynwood, CA 90262 | 2017-07-28 |
| 1134594997 | Corinne Palma | Counselor | 11705 S. Alameda St., Lynwood, CA 90262 | 2015-12-04 |
| 1891175550 | Nancy Bremmer | Counselor | 10705 S. Alameda Street, Los Angels, CA 90262 | 2015-06-08 |
| 1588041347 | Jennifer Montoya | Case Management | 5433 E. Pelleur St., Lynwood, CA 90262 | 2015-04-30 |
| 1124440060 | Susana Gyek Goy | Chiropractor | 11123 Long Beach Blvd. Suite 5, Lynwood Health Center, Lynwood, CA 90262 | 2014-01-13 |
| 1215368956 | Baart Community Healthcare | Clinic/Center | 11315 S. Atlantic Blvd., Lynwood, CA 90262 | 2013-12-05 |
| Find all providers in zip 90262 | ||||
| Taxonomy Code | 302R00000X |
| Grouping | Managed Care Organizations |
| Classification | Health Maintenance Organization |
| (1) A form of health insurance in which its members prepay a premium for the HMO’s health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model. |
| Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 20; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376563957 | Chafik Dakak | Health Maintenance Organization | 3737 Martin Luther King Blvd., Suite 205, Lynwood, CA 90262 | 2006-07-19 |
| 1508060534 | Stephen Lui Md Inc | Health Maintenance Organization | 3625 Martin Luther King Jr Blvd, Suite 5, Lynwood, CA 90262-3509 | 2007-06-13 |
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| 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.