EASTSIDE DIABETES CARE MEDICAL CLINIC, INC. (NPI# 1841500253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841500253 |
| Entity Type | Organization |
| Organization Name | EASTSIDE DIABETES CARE MEDICAL CLINIC, INC. |
| Practice Address |
5836 E Beverly Blvd Los Angeles CA 90022-2824 |
| Practice Telephone | 3237260370 |
| Practice Fax Number | 3237260239 |
| Mailing Telephone | 3237260370 |
| Mailing Fax Number | 3237260239 |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2015-02-27 |
| Authorized Official Name | MRS. ALTAGRACIA A RODRIGUEZ (OFFICE MANAGER) |
| Authorized Official Telephone | 3237260370 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QH0100X |
Clinic/Center Specialization: Health Service |
A33652 | CA | Ambulatory Health Care Facilities |
| Y | 174400000X | Specialist | A33652 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NPI | 1972600880 | 01 | |
| CA | 00A336520 | 05 |
| Street Address |
5836 E BEVERLY BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90022-2824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972600880 | Miguel E Rodriguez | Internal Medicine | 5836 E Beverly Blvd, Los Angeles, CA 90022 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700405701 | Altamed Health Services Corp | Pharmacy | 972 Goodrich Blvd Rm 100, Los Angeles, CA 90022 | 2020-04-10 |
| 1033699426 | Reachwell Home Health Inc | Home Health | 236 1/4 S Atlantic Blvd, Los Angeles, CA 90022 | 2018-08-15 |
| 1326528704 | Shelli Hernandez | Community Health Worker | Enki Health & Research Systems Inc., 1000 Goodrich Blvd., Commerce, CA 90022 | 2018-08-15 |
| 1477071660 | East Los Angeles Womens Center | Counselor | 1431 S. Atlantic Blvd, Los Angeles, CA 90022 | 2017-09-07 |
| 1467974824 | Ena Vilma Hernandez | Registered Nurse | 245 S Fetterly St, Los Angeles, CA 90022 | 2017-07-07 |
| 1437688843 | Maud D Legaspi | Social Worker | 5425 E. Pomona Blvd, Los Angeles, CA 90022 | 2017-06-08 |
| 1548793920 | Harbor Chiropractic, Inc., A Bahan Company | Chiropractor | 5301 Whittier Blvd, Atrium Lower Level, Los Angeles, CA 90022 | 2017-04-04 |
| 1326590423 | Via Care Community Health Center | Clinic/Center | 501 S. Woods Ave, Los Angeles, CA 90022 | 2016-10-25 |
| 1780057950 | Monica Poomiwatracanont | Pharmacist | 5176 E. Whittier Blvd., Los Angeles, CA 90022 | 2015-11-10 |
| 1609277433 | Ethan C. A Lee Dental Inc. | Dentist | 6046 Whittier Blvd., Los Angeles, CA 90022 | 2014-09-11 |
| Find all providers in zip 90022 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255801098 | Maria Elizabeth Botham | Specialist | 8250 W 3rd St Ste 203, Los Angeles, CA 90048-4327 | 2018-12-04 |
| 1154899821 | Adam Garcia-morales | Specialist | 216 S Townsend Ave, Los Angeles, CA 90063-2439 | 2018-11-11 |
| 1174028930 | Sabrena Anne Smith | Specialist | 1680 Vine St Ste 908, Los Angeles, CA 90028-8838 | 2018-03-26 |
| 1538663513 | John Horton | Specialist | 760 Westwood Plaza, Resident Office, Los Angeles, CA 90024 | 2018-03-22 |
| 1598272262 | Ronna Lynne Pearl | Specialist | 3371 Glendale Blvd Ste 215, Los Angeles, CA 90039-1857 | 2018-01-04 |
| 1245754431 | Marla Ellen Mintz | Specialist | 11844 W Pico Blvd Ste 200, Los Angeles, CA 90064-1353 | 2017-07-28 |
| 1730619818 | Emily Ng | Specialist | 8590 W Pico Blvd, Los Angeles, CA 90035-2691 | 2017-06-12 |
| 1871044297 | Katherinne Aucaruri | Specialist | 4225 Blanchard St, Los Angeles, CA 90063-1317 | 2016-10-20 |
| 1720536923 | Jkc Neurology Medical Group Inc | Specialist | 3550 Wilshire Blvd Ste 650, Los Angeles, CA 90010-2440 | 2016-09-15 |
| 1932552916 | Anthony Jose Salvatierra | Specialist | 421 S Manhattan Pl Apt 9, Los Angeles, CA 90020-4175 | 2016-07-14 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90022 |
Please comment or provide details below to improve the information on EASTSIDE DIABETES CARE MEDICAL CLINIC, 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.