ICM MEDICAL GROUP INC (NPI# 1922461300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922461300 |
| Entity Type | Organization |
| Organization Name | ICM MEDICAL GROUP INC |
| Practice Address |
211 N Prairie Ave Inglewood CA 90301-1412 |
| Mailing Address |
Po Box 1698 Inglewood CA 90308-1698 |
| Practice Telephone | 3108550556 |
| Practice Fax Number | 3104199475 |
| Mailing Telephone | 3108550556 |
| Mailing Fax Number | 3104199475 |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2016-04-01 |
| Authorized Official Name | AMANUEL SIMA (PRESIDENT) |
| Authorized Official Telephone | 3108550556 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers |
| Street Address |
211 N PRAIRIE AVE |
| City | INGLEWOOD |
| State | CA |
| Zip Code | 90301-1412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407868417 | Inglewood Imaging Center LLC | Clinic/Center | 211 N Prairie Ave, Suite E, Inglewood, CA 90301-1412 | 2006-08-12 |
| 1003454257 | Advanced Health Preference Group Inc., A Professional Nursing Corporat | Nurse Practitioner | 211 N Prairie Ave, Inglewood, CA 90301-1412 | 2019-12-18 |
| 1831544725 | One Lab LLC | Clinical Medical Laboratory | 211 N Prairie Ave, Suite H, Inglewood, CA 90301-1412 | 2016-04-27 |
| 1639566854 | Medsima Urgent Care Inc | Internal Medicine | 211 N Prairie Ave, Suite A, Inglewood, CA 90301-1412 | 2015-04-26 |
| 1235528092 | Anitha Mitchell Md A Proffessional Corp | Internal Medicine | 211 N Prairie Ave, Inglewood, CA 90301-1412 | 2015-01-16 |
| 1407254881 | Kesha Saucier | Psychologist | 211 N Prairie Ave, Inglewood, CA 90301-1412 | 2014-12-16 |
| 1013156843 | Pulin A Sheth Md, Inc. | Clinic/Center | 211 N Prairie Ave, Inglewood, CA 90301-1412 | 2009-02-18 |
| 1568637957 | National Sleep Solutions | Durable Medical Equipment & Medical Supplies | 211 N Prairie Ave, Inglewood, CA 90301-1412 | 2008-04-25 |
| 1891842670 | Anitha Theresa Mitchell | Specialist | 211 N Prairie Ave, Inglewood, CA 90301-1412 | 2007-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548897945 | Genevieve V. Angel | Registered Nurse | 555 East Hardy Street, Director of Cm Sw, Centinela Hospital Medical Center, Inglewood, CA 90301 | 2020-03-25 |
| 1992338552 | Ralph Kevin Roque | Licensed Practical Nurse | 614 W Manchester Blvd, Inglewood, Ca 90301, 104, Inglewood, CA 90301 | 2020-02-21 |
| 1043841562 | Evelyn Jones | Social Worker | 555 E. Hardy Street, Inglewood, Ca, CA 90301 | 2020-02-03 |
| 1447896444 | Coral Dabarera Edelson | Dietitian, Registered | 110 North La Brea Ave, Inglewood, CA 90301 | 2019-11-25 |
| 1821642125 | Jennifer Robert Umoh | Student in an Organized Health Care Education/Training Program | 412 E Florence Avenue, Inglewood, CA 90301 | 2019-07-25 |
| 1821567751 | Esther Voltaire | Behavior Technician | 619 E Arbor Vitae St, Inglewood, CA 90301 | 2018-11-21 |
| 1902372832 | Pool Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 323 North Prairie Ave, Suite 200, Ingelwood, CA 90301 | 2018-10-18 |
| 1174003594 | Xelnt Healthcare Inc. | Clinic/Center | 501 E Hardy St Ste 425, Inglewood, CA 90301 | 2018-08-15 |
| 1710409321 | Rae Shelston Mcintosh | Licensed Vocational Nurse | 1007 Myrth Ave, Inglewood, CA 90301 | 2017-07-14 |
| 1477093789 | Lewis E Logan II | Counselor | 332 N. Prairie Ave., Suite 417, Inglewood, CA 90301 | 2017-03-06 |
| Find all providers in zip 90301 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| 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 |
|---|---|---|---|---|
| 1700491180 | Omni Family Health | Pharmacy | 4646 N. 1st Street, Fresno, CA 93726-0973 | 2020-09-11 |
| 1083240048 | Michael Anthony Abram | Pharmacy | 3240 Beck Rd, Lompoc, CA 93436-8301 | 2020-03-20 |
| 1043843428 | Community Medical Centers Inc | Pharmacy | 7912 West Lane, Ste. 221, Room 102, Stockton, CA 95210-3159 | 2020-02-13 |
| 1053968289 | California Institute for Men Phcy | Pharmacy | 14901 So Central Ave, Chino, CA 91710 | 2019-08-22 |
| 1447616198 | Beverly Hills Wellness Physicians Corp | Pharmacy | 1703 N Avalon Blvd, Wilmington, CA 90744-1432 | 2016-01-11 |
| 1700242419 | Pacific Rejuvination Medical A Professional Corp | Pharmacy | 7230 Medical Center Dr Ste 100, West Hills, CA 91307-4001 | 2016-01-11 |
| 1174923684 | Planned Parenthood Mar Monte, Inc. | Pharmacy | 1032 A Street, Hayward, CA 94541-4106 | 2014-09-03 |
| 1306263264 | University of Southern California | Pharmacy | 830 S Flower St, Los Angeles, CA 90017-4608 | 2014-03-27 |
| 1730428293 | Mission City Community Network Inc | Pharmacy | 8527 Sepulveda Blvd Ste 131, North Hills, CA 91343-5824 | 2013-02-04 |
| 1700158797 | Van Masteranna Billing Service, Inc | Pharmacy | 22631 Pacific Coast Hwy # 793, Malibu, CA 90265-5036 | 2012-02-06 |
| Find all providers with the same taxonomy | ||||
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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.