St Nicholas Medical Group | |
5520 Santa Monica Blvd Suite 112 Los Angeles CA 90038-2932 | |
(323) 860-9054 | |
(323) 860-9053 |
Full Name | St Nicholas Medical Group |
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Speciality | Internal Medicine |
Location | 5520 Santa Monica Blvd, Los Angeles, California |
Authorized Official Name and Position | Jacob N Flores (PARTNER) |
Authorized Official Contact | 3238609054 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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St Nicholas Medical Group 5520 Santa Monica Blvd Suite 112 Los Angeles CA 90038-2932 Ph: (323) 860-9054 | St Nicholas Medical Group 5520 Santa Monica Blvd Suite 112 Los Angeles CA 90038-2932 Ph: (323) 860-9054 |
NPI Number | 1891026100 |
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Provider Enumeration Date | 01/26/2010 |
Last Update Date | 08/26/2010 |
Medicare PECOS PAC ID | 1759423379 |
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Medicare Enrollment ID | O20100120000601 |
Identifier | Type | State | Issuer |
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1891026100 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0300X | Internal Medicine - Geriatric Medicine | A60865 (California) | Primary |
Provider Name | Jacob N Flores |
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Provider Type | Practitioner - Geriatric Medicine |
Provider Identifiers | NPI Number: 1164469201 PECOS PAC ID: 7719960434 Enrollment ID: I20040611001036 |
Joseph I Kang Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3755 Beverly Blvd, Ste 301, Los Angeles, CA 90004 Phone: 323-664-7777 | |
John L Sherman Md Amc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8635 W 3rd St Ste 485w, Los Angeles, CA 90048 Phone: 310-855-8081 Fax: 310-855-0438 | |
Altamed Health Services Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5425 Pomona Blvd, Los Angeles, CA 90022 Phone: 323-832-7527 Fax: 323-832-7599 | |