CHAMPION MEDICAL GROUP, A MEDICAL CORPORATION (NPI# 1871884205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871884205 |
| Entity Type | Organization |
| Organization Name | CHAMPION MEDICAL GROUP, A MEDICAL CORPORATION |
| Practice Address |
1711 W Temple St Ste 4100 Los Angeles CA 90026-5421 |
| Mailing Address |
2980 N Beverly Glen Cir Suite 100 Los Angeles CA 90077-1726 |
| Practice Telephone | 2134846681 |
| Mailing Telephone | 3104749809 |
| Mailing Fax Number | 8884318819 |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2015-10-05 |
| Authorized Official Name | HERBERT MARSHAK (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2134846681 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | CHAMPION MEDICAL GROUP, A MEDICAL CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144525775 | Champion Medical Group, A Medical Corporation | Non-Pharmacy Dispensing Site | 3211 Van Buren Blvd Ste B, Riverside, CA 92503-5640 | 2011-01-12 |
| 1639460066 | Champion Medical Group, A Medical Corporation | Non-Pharmacy Dispensing Site | 1902 Royalty Dr, Ste 290, Pomona, CA 91767-3030 | 2011-04-19 |
| 1386935716 | Champion Medical Group, A Medical Corporation | Non-Pharmacy Dispensing Site | 1206 E 17th St, Ste 106, Santa Ana, CA 92701-2641 | 2011-04-19 |
| 1417248840 | Champion Medical Group, A Medical Corporation | Non-Pharmacy Dispensing Site | 8121 Van Nuys Blvd, Ste 316, Panorama City, CA 91402-5105 | 2011-04-19 |
| 1164713590 | Champion Medical Group, A Medical Corporation | Non-Pharmacy Dispensing Site | 2777 Pacific Ave, Ste K, Long Beach, CA 90806-2625 | 2011-04-19 |
| Street Address |
1711 W TEMPLE ST STE 4100 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90026-5421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730178369 | Elisabeth Sunghee Youn | Podiatrist | 1711 W Temple St, Suite 5606, Los Angeles, CA 90026-5421 | 2005-10-17 |
| 1033720909 | Lacresiha Geeter | Registered Nurse | 1711 W Temple St, Los Angeles, CA 90026-7329 | 2020-08-13 |
| 1225656770 | Mika Tavai | Licensed Vocational Nurse | 1711 W Temple St, Los Angeles, CA 90026-5421 | 2020-07-10 |
| 1285275263 | Chen Sun | Registered Nurse | 1711 W Temple St, Los Angeles, CA 90026-5421 | 2019-10-01 |
| 1407403439 | Leanna Lynn Ramirez | Licensed Psychiatric Technician | 1711 W Temple St, Los Angeles, CA 90026-5421 | 2019-08-23 |
| 1518514199 | Albert Martinez | Behavior Technician | 1711 W Temple St, Los Angeles, CA 90026-5421 | 2019-08-20 |
| 1063066140 | Pinky Jane Bartolome Biag | Registered Nurse | 1711 W Temple St, Los Angeles, CA 90026-5421 | 2019-07-28 |
| 1982260899 | Anthony Samaan | Student in an Organized Health Care Education/Training Program | 1711 W Temple St, Los Angeles, CA 90026-5421 | 2019-05-15 |
| 1154802346 | Wk Md Medical Group Inc | Family Medicine | 1711 W Temple St, Los Angeles, CA 90026-5421 | 2018-08-24 |
| 1437654589 | Katayoun Abtin | Student in an Organized Health Care Education/Training Program | 1711 W Temple St, Los Angeles, CA 90026-5421 | 2018-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497305684 | Mieshia Gaston | Technician | 831 Lucile Ave, 201, Los Angeles, CA 90026 | 2019-09-19 |
| 1265902928 | Shivangi Amin Md, Inc | Family Medicine | 701 N Alvarado St Fl 1, Los Angeles, CA 90026 | 2018-11-26 |
| 1013402478 | Guillermo Gonzalez Lopez | Social Worker | La Cada, 1773 Griffith Park, Los Angeles, CA 90026 | 2018-06-28 |
| 1720504343 | Nadia Jocelyn Munoz | Counselor | 155 N. Occidental Blvd., Los Angeles, CA 90026 | 2017-08-15 |
| 1518489434 | Paul Keeley | Marriage & Family Therapist | 321 North Larchmont Boulevard, Suite 808, Los Angeles, CA 90026 | 2017-07-12 |
| 1326598079 | Yen-chen Chen | Speech-Language Pathologist | 2836 Sunset Blvd., Los Angeles, CA 90026 | 2016-10-06 |
| 1386038446 | Grace Ann M Navos | Physical Therapy Assistant | 2708 Glassell St, Los Angeles, CA 90026 | 2015-03-26 |
| 1578964227 | Giselle Louise Jones | Social Worker | 1741 Silver Lake Blvd Ste 2a, Los Angeles, CA 90026 | 2014-09-12 |
| 1619394160 | Mary Ann Flores Topico | Nurse Practitioner | 1379 Angelina St., Los Angeles, CA 90026 | 2014-03-22 |
| 1447674981 | Tribeca Pediatrics, PC | Pediatrics | 2920 Sunset Blvd, Tribeca Pediatrics, Los Angeles, CA 90026 | 2014-02-04 |
| Find all providers in zip 90026 | ||||
| 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 | 90026 |
Please comment or provide details below to improve the information on CHAMPION MEDICAL GROUP, A MEDICAL CORPORATION.
| 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.