CROWN CITY MEDICAL GROUP, INC. (NPI# 1962525964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962525964 |
| Entity Type | Organization |
| Organization Name | CROWN CITY MEDICAL GROUP, INC. |
| Practice Address |
1542 E Florence Ave Los Angeles CA 90001-2536 |
| Practice Telephone | 3235840222 |
| Practice Fax Number | 6262961403 |
| Mailing Telephone | 3235840222 |
| Mailing Fax Number | 6262961403 |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2014-07-28 |
| Authorized Official Name | KEVIN B. TYSON (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 6267988792 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL PROVIDER # | GR0041813 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073512836 | Crown City Medical Group, Inc. | Family Medicine | 2661 E Washington Blvd, Pasadena, CA 91107-1412 | 2005-07-14 |
| Street Address |
1542 E FLORENCE AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90001-2536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669471363 | Pacita B Neumann | General Practice | 1542 E Florence Ave, Los Angeles, CA 90001-2536 | 2005-07-15 |
| 1285720326 | Alberto Y Encina | Family Medicine | 1542 E Florence Ave, Los Angeles, CA 90001-2536 | 2006-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730722539 | Lisa Crockom | Technician | 1838 E. Badillo Street Apt 1, Los Angeles, CA 90001 | 2019-10-24 |
| 1679047229 | Rosario Montes | Behavior Technician | 6907 Hooper Ave, Los Angeles, CA 90001 | 2019-01-16 |
| 1467902031 | Fun Dental 4 Kids 2 | Dentist | 1014 E Manchester Ave, Suite I, Los Angeles, CA 90001 | 2016-10-07 |
| 1295100709 | Central City Community Health Center | Clinic/Center | 1236 E Florence Ave, Los Angeles, CA 90001 | 2015-12-09 |
| 1437596327 | Natasha Nasha Andrews | Clinic/Center | 1620 E. 83rd Street, Los Angeles, CA 90001 | 2013-05-31 |
| 1679827943 | Denise Michelle Betters | Counselor | 8019 S Compton Ave., Los Angeles, CA 90001 | 2012-11-07 |
| 1790050763 | Animo Locke Tech Charter High School | Community/Behavioral Health | 810 E. 111th Street, Room # 113 & 114, Los Angeles, CA 90001 | 2012-03-09 |
| 1093021602 | Larthia Renard Dunham | Social Worker | 8019 S. Compton Blvd., Los Angeles, CA 90001 | 2010-08-20 |
| 1114258761 | Central City Comm Hlt Ctr Mobile Unit | General Practice | 5986 Central Avenue, Los Angeles, CA 90001 | 2010-01-21 |
| 1457688517 | Yesenia Cruz | Dental Assistant | 1119 E 64th St., Los Angeles, CA 90001 | 2009-11-11 |
| Find all providers in zip 90001 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063923 | Claude Kathy Marquis | Family Medicine | 400 S June St, Los Angeles, CA 90020-4812 | 2020-11-03 |
| 1376159939 | Margarette Morney-kuanyawo | Family Medicine | 515 S Fuller Ave, Los Angeles, CA 90036-3244 | 2020-09-18 |
| 1780207803 | Julia Solis | Family Medicine | 1414 S Grand Ave Ste 200&380, Los Angeles, CA 90015-3067 | 2020-05-22 |
| 1033739578 | Now Medical | Family Medicine | 1333 S Hill St, Los Angeles, CA 90015-3012 | 2020-04-24 |
| 1710514930 | Los Angeles Medical Center Foundation | Family Medicine | 2010 Wilshire Blvd Fl 2, Los Angeles, CA 90057-3507 | 2020-03-26 |
| 1740817212 | Quality Medical Group Inc | Family Medicine | 5230 Pacific Concourse Dr Ste 110, Los Angeles, CA 90045-6258 | 2020-03-25 |
| 1760012108 | Majid Sabour Md. PC. | Family Medicine | 1125 S Beverly Dr Ste 420, Los Angeles, CA 90035-1191 | 2020-01-24 |
| 1164061461 | Sequoia Quality Health Inc | Family Medicine | 2007 Wilshire Blvd Fl 3, Los Angeles, CA 90057-3519 | 2020-01-03 |
| 1437792447 | Northeast Community Clinic | Family Medicine | 1414 S Grand Ave Ste 300, Los Angeles, CA 90015-3072 | 2019-10-22 |
| 1386298867 | Prompt Healthcare, Inc., A Medical Corporation | Family Medicine | 1972 West 48th Street, #a, Los Angeles, CA 90062 | 2019-08-01 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90001 |
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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.