IMED SURGICAL OF LA PC (NPI# 1619519212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619519212 |
| Entity Type | Organization |
| Organization Name | IMED SURGICAL OF LA PC |
| Practice Address |
11661 San Vicente Blvd Ste 101 Los Angeles CA 90049-5150 |
| Mailing Address |
113 E 39th St New York NY 10016-0968 |
| Practice Telephone | 6317601548 |
| Mailing Telephone | 6317601548 |
| Mailing Fax Number | 6317601548 |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2019-10-15 |
| Authorized Official Name | DR. MICHAEL E JONES (CEO) |
| Authorized Official Telephone | 6317601548 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NA | NA | 01 |
| Street Address |
11661 SAN VICENTE BLVD STE 101 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90049-5150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205309341 | Kianoush Shakib Md Inc | Internal Medicine | 11661 San Vicente Blvd Ste 101, Los Angeles, CA 90049-5150 | 2019-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316564339 | Kepp Family & Group Practice | Marriage & Family Therapist | 12011 San Vincente Blvd, 408, Los Angeles, CA 90049 | 2020-06-26 |
| 1386204493 | Steven J Lehrman | Marriage & Family Therapist | 179 S. Barrington Place, Office A, Los Angeles, CA 90049 | 2019-06-20 |
| 1922562990 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 860 S. Sepulveda Blvd., Los Angeles, CA 90049 | 2019-01-24 |
| 1851864946 | Christie Schnur | Marriage & Family Therapist | 11911 San Vicente Blvd., Los Angeles, CA 90049 | 2019-01-10 |
| 1669954012 | Barbara Jiji Schenk | Marriage & Family Therapist | 520 S. Sepulveda Blvd #402, Los Angeles, CA 90049 | 2018-09-02 |
| 1972090710 | Community Reflections Inc | Counselor | 10020 So. Western Ave, 10020 So. Western Ave, Los Angeles, CA 90049 | 2018-04-17 |
| 1245738830 | Dr. Shirin Tabib LLC | Marriage & Family Therapist | 61133 San Vincent Blvd, Suite 318 A, Los Angeles, CA 90049 | 2018-01-29 |
| 1295240679 | Robert A Brooks | Preventive Medicine | 149 South Barrington Ave, #346, Los Angeles, CA 90049 | 2017-12-07 |
| 1598286478 | Marvin S Serrano | Physical Therapy Assistant | 11740 San Vicente Boulevard Suite 205, Los Angeles, CA 90049 | 2017-06-30 |
| 1972055812 | Evolve Growth Initiatives, LLC | Psychiatric Residential Treatment Facility | 820 Moraga Drive, Los Angeles, CA 90049 | 2016-10-26 |
| Find all providers in zip 90049 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639720097 | Sergey Lyass Md Surgical | Surgery | 8631 W 3rd St # S900e, Los Angeles, CA 90048-5901 | 2019-09-26 |
| 1104317262 | Ryan Alexander Smith | Surgery | 11301 Wilshire Blvd Ofc Va, Los Angeles, CA 90073-1003 | 2018-05-24 |
| 1699215327 | La Surgical Specialists | Surgery | 450 N Greencraig Rd, Los Angeles, CA 90049-2840 | 2017-02-28 |
| 1245681543 | Cina Surgery | Surgery | 3756 Santa Rosalia Dr Ste C100, Los Angeles, CA 90008-3606 | 2016-06-28 |
| 1548622194 | Blair Smart | Surgery | Usc General Surgery Residency Program, 1520 San Pablo Street, Los Angeles, CA 90033-5330 | 2016-03-23 |
| 1053783258 | Michael F. Sedrak, M.d., A Medical Corporation | Surgery | 10336 Wilshire Blvd Apt 602, Los Angeles, CA 90024-4754 | 2015-10-27 |
| 1558737312 | Gene Kyu Lee | Surgery | 1520 San Pablo Street, Hct 4300, Los Angeles, CA 90033 | 2015-08-17 |
| 1851779052 | Michael Fenlon | Surgery | 1520 San Pablo St # 3400, Los Angeles, CA 90033-5310 | 2015-05-08 |
| 1588062566 | Moon Ip | Surgery | 4300 Crenshaw Blvd, Los Angeles, CA 90008-4902 | 2014-12-08 |
| 1629488416 | Cassra Nouri Arbabi | Surgery | 127 S San Vicente Blvd Ste A3100, Los Angeles, CA 90048 | 2014-05-01 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90049 |
Please comment or provide details below to improve the information on IMED SURGICAL OF LA PC.
| 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.