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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

EDGEMONT MEDICAL CLINIC
NPI 1588078166
Family Medicine in Los Angeles, CA

Active since June 11, 2014
4864 SANTA MONICA BLVD, LOS ANGELES, CA 90029(323) 661-2700(323) 661-2702 Get Directions Write a Review

NPPES record last updated: September 23, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

About Edgemont Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDGEMONT MEDICAL CLINIC (NPI 1588078166) is a healthcare organization registered as a family medicine in Los Angeles, California and active in the NPI registry since June 2014. The organization lists Manuk Chulyan, President, as its authorized official.

NPPES Registry Identity

NPI1588078166
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameEDGEMONT MEDICAL CLINIC
Location Address4864 SANTA MONICA BLVDLos Angeles, CA 90029-2634
Mailing Address4864 Santa Monica BlvdLos Angeles, CA 90029-2634 · (323) 661-2700 · Fax (323) 661-2702
Phone(323) 661-2700
Fax(323) 661-2702
Organization SubpartNo
Authorized OfficialManuk ChulyanPresident · (818) 504-7265
Enumeration DateJune 11, 2014
Last NPPES UpdateSeptember 23, 2026
NPPES CertifiedSeptember 23, 2026
✔ NPI 1588078166 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · 20A10630
Definition
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.
Also ListedGeneral PracticeTaxonomy 208D00000X · License 20A10630 (CA)
4864 SANTA MONICA BLVD, Los Angeles, CA 90029
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Other Names 1

Doing Business AsEdgemont Medical Clinic

Other Identifiers 2

Other1043482060CA · Npi
Other1881986826CA · Npi 1881986826

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SPIROS H. MIKELATOS M.D.
General Practice
4864 SANTA MONICA BLVD
LOS ANGELES, CA 90029
Los Angeles County (323) 664-9000
HOLY CROSS URGENT CARE, INC
Clinic/Center (Urgent Care)
4864 SANTA MONICA BLVD
LOS ANGELES, CA 90029
Los Angeles County (323) 661-2700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edgemont Medical Clinic's NPI number?

The NPI number for Edgemont Medical Clinic is 1588078166. It was assigned to this organization in the NPPES registry on June 11, 2014.

Where is Edgemont Medical Clinic located?

Edgemont Medical Clinic is located at 4864 Santa Monica Blvd, Los Angeles, CA 90029. The listed phone number is (323) 661-2700.

What is Edgemont Medical Clinic's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Edgemont Medical Clinic was last updated on September 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 24 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.