| St. John's Urgent Care & Medical Corporation | |
|
1119 N Western Ave Ste G Los Angeles CA 90029-1070 | |
| (323) 957-9300 | |
| (323) 957-9315 |
| Full Name | St. John's Urgent Care & Medical Corporation |
|---|---|
| Speciality | General Practice |
| Location | 1119 N Western Ave Ste G, Los Angeles, California |
| Authorized Official Name and Position | Mike M Rostami (PHYSICIAN/CEO) |
| Authorized Official Contact | 3239579300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. John's Urgent Care & Medical Corporation 1119 N Western Ave Ste G Los Angeles CA 90029-1070 Ph: (323) 957-9300 | St. John's Urgent Care & Medical Corporation 1119 N Western Ave Ste G Los Angeles CA 90029-1070 Ph: (323) 957-9300 |
| NPI Number | 1710073390 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 04/01/2020 |
| Medicare PECOS PAC ID | 1254372584 |
|---|---|
| Medicare Enrollment ID | O20050517001061 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710073390 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Neil D Katchman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053366047 PECOS PAC ID: 1153399019 Enrollment ID: I20040920000520 |
| Provider Name | Mike M Rostami |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1720135726 PECOS PAC ID: 7012999121 Enrollment ID: I20050622001381 |
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