CLINICA SANTA MARTA MEDICAL GROUP (NPI# 1417380254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417380254 |
| Entity Type | Organization |
| Organization Name | CLINICA SANTA MARTA MEDICAL GROUP |
| Other Organization Name | CLINICA SANTA MARTA |
| Practice Address |
3742 Whittier Blvd Los Angeles CA 90023-1704 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 3237804100 |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2013-08-15 |
| Authorized Official Name | KENNY HEINE (VP OF OPERATIONS) |
| Authorized Official Telephone | 8589641506 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | PA19472 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Clinica Santa Marta | Doing Business As Name - Organization |
| Street Address |
3742 WHITTIER BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90023-1704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083747612 | Stephen Eugene Calvert | General Practice | 3742 Whittier Blvd, Los Angeles, CA 90023-1704 | 2007-03-13 |
| 1366699027 | Clinica Santa Marta Medical Group, Inc | General Practice | 3742 Whittier Blvd, Los Angeles, CA 90023-1704 | 2008-08-25 |
| 1376724518 | Victor Manuel Quinones | Physician Assistant | 3742 Whittier Blvd, Los Angeles, CA 90023-1704 | 2007-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104470384 | Chan Family Medical Corp | General Practice | 4070 E. Olympic Blvd, Los Angeles, CA 90023 | 2019-07-26 |
| 1275059511 | Jeff Moreno | Psychoanalyst | 550 Vermount Ave, Los Angeles, CA 90023 | 2017-08-18 |
| 1457714297 | Isabel Garcia | Counselor | 4543 Sabina Street, Los Angeles, CA 90023 | 2016-03-30 |
| 1275950115 | Daniel Lemor | Ophthalmology | 4036 Whittier Blvd Ste 202, Los Angeles, CA 90023 | 2014-03-27 |
| 1073951992 | Behavioral Health Services, Inc. | Community/Behavioral Health | 2515 Whittier Blvd., Los Angeles, CA 90023 | 2013-06-13 |
| 1003115312 | H.r.imankhan,dds,inc | Dentist | 3356 E. Olympic Blvd, Los Angeles, CA 90023 | 2011-03-25 |
| 1508006297 | Ricca Tinnin | Physician Assistant | 1200 N State St., Dept E.r., La, CA 90023 | 2009-02-20 |
| 1538366851 | Sun Heung Lui | Counselor | 3421 E. Olympic Blvd., Los Angeles, CA 90023 | 2007-06-29 |
| 1851519623 | Atlantic Recovery Services | Community/Behavioral Health | 3225 Flunter St, Estrada Courts Sea, Los Angeles, CA 90023 | 2007-04-24 |
| 1548486947 | Manasseh C Nwaigwe | General Practice | 1159 S. Lorena St, Los Angeles, CA 90023 | 2007-04-17 |
| Find all providers in zip 90023 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730624719 | St. John's Well Child and Family Center Inc | Non-Pharmacy Dispensing Site | 326 W 23rd St, Los Angeles, CA 90007-2612 | 2016-12-29 |
| 1932395092 | Glenville Medical Group, A Medical Corporation | Non-Pharmacy Dispensing Site | 1531 Glenville Dr, Los Angeles, CA 90035-3107 | 2007-09-21 |
| 1265441216 | Randy L Peters | Non-Pharmacy Dispensing Site | 3198 W 7th St Apt 318, Los Angeles, CA 90005-1659 | 2006-08-07 |
| 1891245619 | Keith L. Gurnick, D.p.m. | Non-Pharmacy Dispensing Site | 2080 Century Park E, Suite 705, Los Angeles, CA 90067-2001 | 2016-10-04 |
| 1770962946 | R Roland Lopez, M.d., Inc. | Non-Pharmacy Dispensing Site | 1711 W Temple St, Suite 4100, Los Angeles, CA 90026-5421 | 2015-05-21 |
| 1386021475 | R Roland Lopez, M.d., Inc. | Non-Pharmacy Dispensing Site | 5301 Whittier Blvd, Suite B, Los Angeles, CA 90022-4038 | 2015-04-28 |
| 1033501101 | Ais Medical Foods, Inc. | Non-Pharmacy Dispensing Site | 8631 W 3rd St, Suite 1145e, Los Angeles, CA 90048-5901 | 2015-02-26 |
| 1255749099 | Morningside Primary Care Medical Center Mc Inc A Nevada Corporation | Non-Pharmacy Dispensing Site | 617 W Manchester Ave, Los Angeles, CA 90044-5718 | 2014-07-24 |
| 1386058402 | Arj Medical, Inc. | Non-Pharmacy Dispensing Site | 5655 E Beverly Blvd, Los Angeles, CA 90022-2803 | 2014-06-17 |
| 1043624489 | Daniel Capen, M.d., A Professional Corporation | Non-Pharmacy Dispensing Site | 6200 Wilshire Blvd, Suite 910, Los Angeles, CA 90048-5801 | 2014-06-13 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90023 |
Please comment or provide details below to improve the information on CLINICA SANTA MARTA MEDICAL GROUP.
| 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.