ST NICHOLAS MEDICAL GROUP (NPI# 1982808622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982808622 |
| Entity Type | Organization |
| Organization Name | ST NICHOLAS MEDICAL GROUP |
| Practice Address |
5520 Santa Monica Blvd Suite 112 Los Angeles CA 90038-2932 |
| Mailing Address |
5520 Santa Monica Blvd Suite 112 Los Angeles CA 90038 |
| Practice Telephone | 3238609054 |
| Practice Fax Number | 3238609053 |
| Mailing Telephone | 3238609054 |
| Mailing Fax Number | 3238609053 |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2010-02-08 |
| Authorized Official Name | DR. LORENZO ESGUERRA TIZON (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3238609054 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A40329 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891026100 | St Nicholas Medical Group | Internal Medicine | 5520 Santa Monica Blvd, Suite 112, Los Angeles, CA 90038-2932 | 2010-01-26 |
| Street Address |
5520 SANTA MONICA BLVD SUITE 112 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90038-2932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275547879 | Lorenzo Tizon | Internal Medicine | 5520 Santa Monica Blvd, Suite 112, Los Angeles, CA 90038-2932 | 2006-07-28 |
| 1891026100 | St Nicholas Medical Group | Internal Medicine | 5520 Santa Monica Blvd, Suite 112, Los Angeles, CA 90038-2932 | 2010-01-26 |
| 1821142670 | St Andrews Medical Group Inc | Specialist | 5520 Santa Monica Blvd, Suite 112, Los Angeles, CA 90038-2932 | 2007-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114568698 | Kaiser Foundation Health Plan Inc | Pharmacy | 7007 Romaine St, Los Angeles, CA 90038 | 2019-10-04 |
| 1134685613 | National Vision Inc | Technician/Technologist | 5818 Santa Monica Boulevard, Los Angeles, CA 90038 | 2019-02-20 |
| 1023530482 | Christopher Michael Colon | Case Manager/Care Coordinator | 1224 N Vine Street, Los Angeles, CA 90038 | 2017-07-07 |
| 1841736477 | Randall Smith | Counselor | 7000 Romaine, 207-208, La, CA 90038 | 2017-01-06 |
| 1780050278 | Craig V. Smith, M.d., A Professional Medical Corporation | Internal Medicine | 6711 Melrose Ave., Los Angeles, CA 90038 | 2015-08-19 |
| 1033585534 | M2 Recovery, Inc. | Clinic/Center | 6715 Melrose Ave., Los Angeles, CA 90038 | 2015-08-19 |
| 1457760522 | Lital Shvarts | Psychologist | 6311 Romaine St Ste 7329, Los Angeles, CA 90038 | 2014-08-04 |
| 1144658071 | Aaron Niemi | Acupuncturist | 1011 North Cole Ave, Los Angeles, CA 90038 | 2013-11-01 |
| 1013351139 | Suren Vardanyan | Non-emergency Medical Transport (VAN) | 1208 N Gower St, #201, Los Angeles, CA 90038 | 2013-04-19 |
| 1093912966 | Tina Robinson | Registered Nurse | 1224 Vine St., Los Angeles, CA 90038 | 2007-07-02 |
| Find all providers in zip 90038 | ||||
| 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 | 90038 |
Please comment or provide details below to improve the information on ST NICHOLAS 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.