MEDI MEDI COMMUNITY HEALTH CENTER (NPI# 1154892875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154892875 |
| Entity Type | Organization |
| Organization Name | MEDI MEDI COMMUNITY HEALTH CENTER |
| Practice Address |
11900 Avalon Blvd Ste 100 Los Angeles CA 90061-2867 |
| Mailing Address |
348 E Olive Ave Ste K Burbank CA 91502-1250 |
| Practice Telephone | 3239992838 |
| Enumeration Date | 2018-12-06 |
| Last Update Date | 2018-12-19 |
| Authorized Official Name | ANDY PISKOULIAN (FOUNDER /CEO) |
| Authorized Official Telephone | 3102007636 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 111N00000X | Chiropractor | Chiropractic Providers | ||
| N | 122300000X | Dentist | Dental Providers | ||
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers | ||
| N | 183500000X | Pharmacist | Pharmacy Service Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4433 Tweedy Blvd, South Gate, CA 902806303 | 3239992838 | |
| 348 E Olive Ave Ste K, Burbank, CA 915021250 | 3102007636 | |
| 999 N Tustin Ave, Santa Ana, CA 927053528 | 3239992838 |
| Street Address |
11900 AVALON BLVD STE 100 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90061-2867 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386177129 | Denis Wadzani | Registered Nurse | 11900 Avalon Blvd Ste 100, Los Angeles, CA 90061-2867 | 2017-04-08 |
| 1952901969 | Elechi M Egeonuigwe | Nurse Practitioner | 11900 Avalon Blvd Ste 100, Los Angeles, CA 90061-2867 | 2020-10-28 |
| 1912533860 | Maria Lemus | Nurse Practitioner | 11900 Avalon Blvd Ste 100, Los Angeles, CA 90061-2867 | 2020-03-22 |
| 1487172656 | Caroline Ngwoke | Nurse Practitioner | 11900 Avalon Blvd Ste 100, Los Angeles, CA 90061-2867 | 2017-09-07 |
| 1275066029 | Ijeoma Ike | Registered Nurse | 11900 Avalon Blvd Ste 100, Los Angeles, CA 90061-2867 | 2017-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447882782 | Golden State Recuperative Care, Inc. | Lodging | 153 E. 110th St, Los Angeles, CA 90061 | 2020-02-05 |
| 1235695974 | Phyllis Kirby Tisdale | Nurse Practitioner | 145 E 124th Street, Los Angeles, CA 90061 | 2019-02-19 |
| 1003160003 | Alicia Vera | Counselor | 245 E 120th Street, Los Angeles, CA 90061 | 2012-10-30 |
| 1194044974 | Helping Kids To Recover, Inc. | Substance Abuse Rehabilitation Facility | 12628 Avalon Boulevard, Los Angeles, CA 90061 | 2010-05-19 |
| 1124202817 | David Anthony Martinez | Counselor | 11900 S. Avalon Blvd, 1, Los Angeles, CA 90061 | 2007-12-18 |
| 1255538690 | Ceed Security Services Inc | Durable Medical Equipment & Medical Supplies | 12815 South Avalon Blvd, Los Angeles, CA 90061 | 2007-06-29 |
| 1134335128 | Parklane Medical Group | Family Medicine | 12900 South Avalon Bl., Los Angeles, CA 90061 | 2007-05-15 |
| 1598892184 | Jose Rodriguez | Counselor | 11900 S. Avalon Blvd., Suite 200, Los Angeles, CA 90061 | 2007-02-28 |
| 1316182975 | Luis Rabago | Counselor | 11900 Avalon Blvd, Suite 200, Los Angeles, CA 90061 | 2008-12-11 |
| 1619169406 | Emmanuel A Ayodele | General Practice | 11126 S Main St, Los Angeles, CA 90061 | 2007-08-15 |
| Find all providers in zip 90061 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1609403807 | Doctors On The Go Professional Group Corp. | General Practice | 3325 Wilshire Blvd Ste 210, Los Angeles, CA 90010-1718 | 2020-03-26 |
| 1568001584 | Ahdout Health Services, Inc. | General Practice | 2121 Avenue of The Stars # Ll20, Los Angeles, CA 90067-5010 | 2019-12-23 |
| 1104470384 | Chan Family Medical Corp | General Practice | 4070 E. Olympic Blvd, Los Angeles, CA 90023 | 2019-07-26 |
| 1972064004 | Divine Help Medical Group Inc | General Practice | 1711 W Temple St Unit 5613, Los Angeles, CA 90026-5421 | 2019-03-29 |
| 1942767801 | Plaza Health Services Inc. | General Practice | 11111 Santa Monica Blvd Ste 200, Los Angeles, CA 90025-3333 | 2019-02-27 |
| 1124536289 | Edward Meltser | General Practice | 469 N Alfred St, Los Angeles, CA 90048-2504 | 2018-01-11 |
| 1023524980 | St. Johns Urgent Care & Medical Corporation | General Practice | 1138 N Western Ave, Los Angeles, CA 90029-1702 | 2017-12-14 |
| 1992234199 | David Ghods | General Practice | 3631 Crenshaw Blvd Ste 109, Los Angeles, CA 90016-4869 | 2017-06-09 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90061 |
Please comment or provide details below to improve the information on MEDI MEDI COMMUNITY HEALTH CENTER.
| 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.