SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP (NPI# 1891873303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891873303 |
| Entity Type | Organization |
| Organization Name | SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP |
| Practice Address |
11668 Sherman Way N Hollywood CA 91605-5831 |
| Mailing Address |
393 E Walnut St 3rd Fl Phr Group & Provider Enrollment Pasadena CA 91188-0001 |
| Practice Telephone | 8185036800 |
| Mailing Telephone | 6264057914 |
| Mailing Fax Number | 6264054600 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2019-11-11 |
| Authorized Official Name | EDWARD M ELLISON JR. (EXECUTIVE MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8776080044 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| 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 |
| 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 |
| 1013409044 | Southern California Permanente Medical Group | Health Maintenance Organization | 2626 Colorado Blvd, Los Angeles, CA 90041-1070 | 2018-06-05 |
| Street Address |
11668 SHERMAN WAY |
| City | N HOLLYWOOD |
| State | CA |
| Zip Code | 91605-5831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558992982 | Dr Fuscaldos Health and Wellness Center Inc | Clinic/Center | 7537 Laurel Canyon Blvd, North Hollywood, CA 91605 | 2020-02-04 |
| 1588191274 | Concord Home Health Care | Home Health | 6824 Radford Ave, Suite 1, North Hollywood, CA 91605 | 2017-05-12 |
| 1487102935 | Crystal Medical Transportation,inc | Non-emergency Medical Transport (VAN) | 8001 Laurel Canyon Blvd Ste 101, N Hollywood, CA 91605 | 2016-09-13 |
| 1891248050 | Teesdale Villa, Inc. | Assisted Living Facility | 7663 Teesdale Avenue, North Hollywood, CA 91605 | 2016-07-25 |
| 1487011623 | Sandra Gutierrez | Counselor | 8330 Lankershim Blvd, North Hollywood, CA 91605 | 2016-01-19 |
| 1104219849 | Next Door Home Care, Inc. | Home Health | 6829 Lankershim Blvd., #12, North Hollywood, CA 91605 | 2015-03-05 |
| 1427458033 | Normandy Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 12914-b Sherman Way, North Hollywood, CA 91605 | 2014-09-02 |
| 1285048645 | Armcare Hospice, Inc. | Hospice Care, Community Based | 7253 Ethel Ave, North Hollywood, CA 91605 | 2014-06-13 |
| 1306183660 | Shadi Rezai | Obstetrics & Gynecology | Valley Community Healthcare, 6801 Coldwater Canyon Avenue, North Hollywood, CA 91605 | 2013-01-07 |
| 1700171139 | Sachiyo Shiraki | Marriage & Family Therapist | 754 Vanscoy Ave., North Hollywood, CA 91605 | 2011-06-14 |
| Find all providers in zip 91605 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295987014 | Bmi Solutions Inc. | Clinical Medical Laboratory | 11490 Burbank Blvd, Suite 6-c, N Hollywood, CA 91601-2389 | 2008-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386746 | Medlab2020 Inc | Clinical Medical Laboratory | 1594 N Main St, Orange, CA 92867-3443 | 2020-11-05 |
| 1851992127 | Predicine, Inc. | Clinical Medical Laboratory | 3555 Arden Rd, Hayward, CA 94545-3922 | 2020-11-03 |
| 1205435989 | Bioanalysis Diagnostic Laboratories | Clinical Medical Laboratory | 18173 Pioneer Blvd Ste K, Artesia, CA 90701-3988 | 2020-10-22 |
| 1164021085 | Integrated Laboratories Advisory Group, Inc. | Clinical Medical Laboratory | 7 W Figueroa St Ste 300, Santa Barbara, CA 93101-3189 | 2020-10-21 |
| 1053910273 | Onsite Phlebotomy Solutions | Clinical Medical Laboratory | 1040 S Mount Vernon Ave # G-276, Colton, CA 92324-4228 | 2020-10-19 |
| 1730787649 | Central California Testing, Inc | Clinical Medical Laboratory | 7737 Meany Ave Ste B9, Bakersfield, CA 93308-5267 | 2020-10-13 |
| 1518565514 | Clarity Mobile Venture LLC | Clinical Medical Laboratory | 651 World Way, Los Angeles, CA 90045-5815 | 2020-10-12 |
| 1083212351 | Telomere Diagnostics, Inc. | Clinical Medical Laboratory | 2688 Middlefield Rd Ste A, Redwood City, CA 94063-3483 | 2020-10-09 |
| 1588261127 | Safesite LLC | Clinical Medical Laboratory | 26660 Agoura Rd, Calabasas, CA 91302-1954 | 2020-10-07 |
| 1366049447 | Sts Lab 1 LLC | Clinical Medical Laboratory | 2302 Trade Zone Blvd Rm 100, San Jose, CA 95131-1819 | 2020-10-02 |
| Find all providers with the same taxonomy | ||||
| City | N HOLLYWOOD |
| Zip Code | 91605 |
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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.