SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP – NPI #1124269717
Clinical Medical Laboratory

(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP is a clinical medical laboratory located in LOS ANGELES, CA. NPPES has assigned the NPI number 1124269717 to SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP on March 12, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 291U00000X from the Health Care Provider Taxonomy code set, which is classified as Clinical Medical Laboratory.

The NPI profile was previously updated about 5 years ago on Nov 02, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP below.

NPI Profile for
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP

NPI Number
1124269717
Enumeration Date

(more than 17 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
Primary location
4580 ELECTRONICS PL
LOS ANGELES, CA 90039-1008
Phone: (818) 502-5141 Fax:
Mailing address
393 E WALNUT ST
3RD FLOOR PHR GROUP & PROVIDER ENROLLMENT
PASADENA, CA 91188-0001
Phone: (626) 405-7914 Fax: (626) 405-4600
Organization Subpart
No
Authorized Official
RAMIN DAVIDOFF
EXECUTIVE MEDICAL DIRECTOR
Phone: (877) 608-0044
Updated
Certification Date
Nov 02, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
291U00000X
- Clinical Medical Laboratory (Primary)
332H00000X
- Eyewear Supplier

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Endpoint type
SOAP URL
Endpoint Description
CAREQUALITY
Content Type
OTHER
Affiliation
N
Endpoint Location
4580 ELECTRONICS PL,
LOS ANGELES, CA 77025-1669