PROSPECT MEDICAL GROUP AZ, INC. (NPI# 1366037152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366037152 |
| Entity Type | Organization |
| Organization Name | PROSPECT MEDICAL GROUP AZ, INC. |
| Practice Address | 3415 S Sepulveda Blvd Fl 9 Los Angeles CA 90034-6060 |
| Practice Telephone | 3109434500 |
| Mailing Address | 3415 S Sepulveda Blvd Fl 9 Los Angeles CA 90034-6060 |
| Mailing Telephone | 3109434500 |
| Certification Date | 2021-03-04 |
| Enumeration Date | 2021-03-04 |
| Last Update Date | 2021-03-04 |
| Authorized Official Telephone | 3109434500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | Group | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians |
| Street Address | 3415 S SEPULVEDA BLVD FL 9 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90034-6060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972914877 | Aura Walker | Counselor | 3415 S Sepulveda Blvd Ste 1122, Los Angeles, CA 90034-6060 | 2014-05-13 |
| 1073542791 | Minh-Thu Thi Le | Clinical Neuropsychologist | 3415 S Sepulveda Blvd, Fl 11, Los Angeles, CA 90034-6060 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104412857 | Jimmie Lee Tyler | Rehabilitation Practitioner | 3200 Motor Avenue, Los Angeles, CA 90034 | 2020-12-16 |
| 1154946655 | Pdi Health Ca LLC | Clinic/Center · Radiology, Mobile | 3415 South Sepulveda Blvd Ste 1100, Los Angeles, CA 90034 | 2020-06-10 |
| 1518582014 | Pdi Health Ca LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 3415 South Sepulveda Blvd Ste 1100, Los Angeles, CA 90034 | 2020-06-10 |
| 1902467996 | Jessie Alexandra Mccurdy | Marriage & Family Therapist | 3200 Motor Ave, Los Angeles, CA 90034 | 2019-06-21 |
| 1154888063 | Lanmc Corporation | Community/Behavioral Health | 1920 S. Robertson Blvd., Los Angeles, CA 90034 | 2019-02-27 |
| 1265999551 | Sang Thi Kim Nguyen | Pharmacist | 6041 Cadillac Ave., Kaiser Wla Outpatient 24hr Pharmacy, Los Angeles, CA 90034 | 2019-02-22 |
| 1225510688 | Shannon Kris Jacobson | Social Worker | 3200 Motor Ave, Los Angeles, CA 90034 | 2018-09-02 |
| 1982184230 | Maria Lynda Ramos-Carver | Student in an Organized Health Care Education/Training Program | 3200 Motor Ave, Los Angeles, CA 90034 | 2018-08-16 |
| 1518447952 | Sonia Maribel Nochez | Marriage & Family Therapist | 3200 Motor Ave, Los Angeles, CA 90034 | 2018-08-15 |
| 1023597325 | Angela Lena Guilfoyle | Social Worker · Clinical | 3200 Motor Ave, Los Angeles, CA 90034 | 2018-08-08 |
| Find all providers in zip 90034 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255939674 | Kiira Health Practice Ca PC | 123 S Figueroa St Apt 1202, Los Angeles, CA 90012-5490 | 2020-10-16 | |
| 1851913917 | St Bishoy Medical Group | 8545 Saturn St Apt 103, Los Angeles, CA 90035-3658 | 2020-05-12 | |
| 1609403807 | Doctors On The Go Professional Group Corp. | 3325 Wilshire Blvd Ste 210, Los Angeles, CA 90010-1718 | 2020-03-26 | |
| 1568001584 | Ahdout Health Services, Inc. | 2121 Avenue of The Stars # Ll20, Los Angeles, CA 90067-5010 | 2019-12-23 | |
| 1114560083 | Sin Fronteras Health and Wellness Center, Inc, A Professional Corporat · Sin Fronteras Health and Wellness Center | 6006 Whittier Blvd, Los Angeles, CA 90022-4402 | 2019-10-23 | |
| 1104470384 | Chan Family Medical Corp | 4070 E. Olympic Blvd, Los Angeles, CA 90023 | 2019-07-26 | |
| 1972064004 | Divine Help Medical Group Inc | 1711 W Temple St Unit 5613, Los Angeles, CA 90026-5421 | 2019-03-29 | |
| 1942767801 | Plaza Health Services Inc. | 11111 Santa Monica Blvd Ste 200, Los Angeles, CA 90025-3333 | 2019-02-27 | |
| 1184181943 | Time Medical Biotech | 815 S Ardmore Ave, Los Angeles, CA 90005-2597 | 2019-02-27 | |
| 1215429493 | Milton Medical Clinic, P.C. | 4643 Beverly Blvd Ste 101, Los Angeles, CA 90004 | 2018-06-04 | |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063533552 | Prospect Northwest Orange County Medical Group Inc. · Prospect Nwoc Medical Group Inc. | Health Maintenance Organization | 1920 E 17th St, Suite 200, Santa Ana, CA 92705-8626 | 2007-04-02 |
| 1760719793 | Prospect Women's Medical Group, P.C. | Obstetrics & Gynecology · Obstetrics | 120 Prospect Ave, Hackensack, NJ 07601-2256 | 2009-11-12 |
| 1285931865 | Poudre Valley Medical Group, LLC · Uchealth Medical Group | Internal Medicine · Endocrinology, Diabetes & Metabolism | 1106 E Prospect Rd Ste 100, Fort Collins, CO 80525-5304 | 2011-02-17 |
| 1518262708 | Poudre Valley Medical Group, LLC · Uchealth Diabetes and Endocrinology Clinic - Prospect | Internal Medicine · Endocrinology, Diabetes & Metabolism | 1106 E Prospect Rd, Ste 100, Fort Collins, CO 80525-5306 | 2011-01-19 |
| 1528071008 | Genesis Family Care Medical Group, Inc. · Pacific Coast Family Medical Group | Internal Medicine | 520 N Prospect Avenue, Suite 102, Redondo Beach, CA 90277-3041 | 2006-08-14 |
| 1144677568 | Prospect Ct Medical Foundation, Inc. · Medical Group | Surgery | 71 Haynes St, Miller Bldg., Floor G, Manchester, CT 06040-4131 | 2016-05-16 |
| 1255710067 | Synergy Specialists Medical Group · Synergy Orthopedic Specialists Medical Group | Specialist | 230 Prospect Pl, Suite 230, Coronado, CA 92118-1978 | 2015-05-26 |
| 1194045914 | Care Station Medical Group, Pa · Care Station Medical Group | General Practice | 456 Prospect Ave, West Orange, NJ 07052-4112 | 2010-06-03 |
| 1114198504 | Prospect Medical Group | Specialist | 15 Woodcrest Dr, Syosset, NY 11791-3036 | 2008-03-13 |
| 1558411975 | Tactical Medical Group Inc. | Emergency Medicine | 250 Prospect Pl, Coronado, CA 92118-1943 | 2007-01-10 |
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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.