ILLUMINARY MEDICAL GROUP, PC (NPI# 1487276812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487276812 |
| Entity Type | Organization |
| Organization Name | ILLUMINARY MEDICAL GROUP, PC |
| Practice Address |
2623 E Slauson Ave Huntington Park CA 90255-2926 |
| Mailing Address |
Po Box 4419 Woodland Hills CA 91365-4419 |
| Practice Telephone | 3235831931 |
| Mailing Telephone | 8183409988 |
| Mailing Fax Number | 8189360427 |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2020-05-07 |
| Authorized Official Name | JIM SERAJ (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9492950342 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Illuminary Medical Group, PC | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 13100 Studebaker Rd, Norwalk, CA 906502500 | 5628683751 | |
| 4060 Whittier Blvd, Los Angeles, CA 900232526 | 3232685514 |
| Street Address |
2623 E SLAUSON AVE |
| City | HUNTINGTON PARK |
| State | CA |
| Zip Code | 90255-2926 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407807084 | Ankica Milosavljevic | Anesthesiology | 2623 E Slauson Ave, Huntington Park, CA 90255-2926 | 2006-05-16 |
| 1710549803 | Karina Michelle Parra | Physician Assistant | 2623 E Slauson Ave, Huntington Park, CA 90255-2926 | 2019-06-28 |
| 1841788783 | Andrew Luna | Physician Assistant | 2623 E Slauson Ave, Huntington Park, CA 90255 | 2018-04-26 |
| 1508384462 | Janet Nguyen | Nurse Practitioner | 2623 E Slauson Ave, Huntington Park, CA 90255-2926 | 2017-08-31 |
| 1811426828 | Josephine Kristy Capili | Physician Assistant | 2623 E Slauson Ave, Huntington Park, CA 90255-2926 | 2017-06-05 |
| 1053747121 | Huntington Park Emergency Physicians, Inc | Emergency Medicine | 2623 E Slauson Ave, Huntington Park, CA 90255-2926 | 2013-09-20 |
| 1124450143 | Kelly A Morin | Physician Assistant | 2623 E Slauson Ave, Huntington Park, CA 90255-2926 | 2013-08-01 |
| 1891059127 | Chhp Holdings II, LLC | General Acute Care Hospital | 2623 E Slauson Ave, Huntington Park, CA 90255-2926 | 2012-07-02 |
| 1891083804 | Kathleen Ahn | Nurse Practitioner | 2623 E Slauson Ave, Huntington Park, CA 90255-2926 | 2011-07-12 |
| 1235309907 | Peter T Katsiyiannis, Md, Inc. | Internal Medicine | 2623 E Slauson Ave, Huntington Park, CA 90255-2926 | 2008-03-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922659424 | Maria Hurtado | Behavior Technician | California St & Pacific Blvd, Walnut Park, CA 90255 | 2019-09-25 |
| 1356803555 | Cdf Centro De Desarrollo Familiar | Social Worker | 2677 Zoe Ave Suite 120, Huntington Park, CA 90255 | 2019-04-05 |
| 1710457908 | Toure Marshawn Curry | Rehabilitation Practitioner | 2677 Zoe Ave #304, Huntington Park, CA 90255 | 2018-11-29 |
| 1508366584 | Kalie Marie Baker | Optometrist | 2614 Gage Ave, Huntington Park, CA 90255 | 2018-02-16 |
| 1134633027 | Alicia Rizkalla | Case Manager/Care Coordinator | Altamed Pace, 1900 Slauson Street, Huntington Park, CA 90255 | 2017-11-30 |
| 1205353760 | All Care One Community Health Center | Chiropractor | 7300 Santa Fe Avenue, Huntington Park, CA 90255 | 2017-08-25 |
| 1447613559 | Peter Vue | Respiratory Therapist, Certified | 6208 Seville Ave., Huntington Park, CA 90255 | 2016-04-05 |
| 1558720029 | Dr. Edmond Janfaza Dds, Inc. | Dentist | 2675 E. Slauson Ave, #300, Huntington Park, CA 90255 | 2016-02-12 |
| 1649650979 | Samuel Zaki Dds Inc | Dentist | 7221 Pacific Blvd, Huntington Park, CA 90255 | 2015-06-02 |
| 1376945808 | Karla Zuniga | Case Manager/Care Coordinator | 3638 E 61st Street, Huntington Park, CA 90255 | 2014-09-16 |
| Find all providers in zip 90255 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
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|---|---|---|---|---|
| 1043830813 | Ikigai Physician Group Inc | Hospitalist | 1523 Main St, Fortuna, CA 95540-2430 | 2020-04-22 |
| 1760012959 | Mylea N Wiley Md Inc. | Hospitalist | 6246 N 1st St. Ste 101, Fresno, CA 93710-5480 | 2020-01-16 |
| 1972152072 | The Hospitalist Group, LLC | Hospitalist | 5150 E Pacific Coast Hwy Ste 500, Long Beach, CA 90804-3328 | 2019-09-10 |
| 1871092254 | Andrew Pascual | Hospitalist | 4929 Van Nuys Blvs, Sherman Oaks, CA 91403 | 2018-02-12 |
| 1871025957 | Saba Arshad | Hospitalist | 30924 Granger Ave, Union City, CA 94587-1621 | 2017-03-29 |
| 1124481098 | Clari Nguyen | Hospitalist | 9455 Clairemont Mesa Blvd # Ca92123, San Diego, CA 92123-1297 | 2016-03-30 |
| 1427410539 | Vrs Enterprises LLC | Hospitalist | 2088 Westminster Dr, Riverside, CA 92506-5526 | 2016-03-28 |
| 1912378324 | Huntington Specialist & Nursing Corporation | Hospitalist | 517 S Myrtle Ave, 101, Monrovia, CA 91016-2825 | 2015-10-12 |
| 1639551435 | Jaafar Al-dahwi | Hospitalist | 847 Lemieux Ln, Clovis, CA 93619-5702 | 2015-06-29 |
| 1578959318 | Hospitalist Group of Montebello Inc | Hospitalist | 817 S Main St Ste D, Corona, CA 92882-3407 | 2015-04-08 |
| Find all providers with the same taxonomy | ||||
| City | HUNTINGTON PARK |
| Zip Code | 90255 |
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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.