SAN JUDAS MEDICAL GROUP
NPI 1609913441
Specialist in Los Angeles, CA
NPI Status: Active since January 31, 2007
Contact Information
2972 WILSHIRE BLVD
LOS ANGELES, CA
ZIP 90010
Phone: (213) 484-0000
Fax: (213) 387-0011
- Organization
- Specialist
- CLIA Number: 05D0894038
- CLIA Cert. Type: Community Clinic
- CLIA Exp. Date: 06-13-2026
About SAN JUDAS MEDICAL GROUP
This page provides the complete NPI Profile along with additional information for San Judas Medical Group, a provider established in Los Angeles, California operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1609913441 assigned on January 2007. The practitioner's primary taxonomy code is 174400000X with license number A48731 (CA). The provider is registered as an organization and their NPI record was last updated 11 years ago. San Judas Medical Group operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as San Judas Medical Group. The authorized official of this NPI record is Dr. Nejat Rostami M.d. (Medical Director)
- NPI
- 1609913441
- Provider Legal Name
- NEJAT ROSTAMI MEDICAL GROUP INC
- Other Organization Name
- SAN JUDAS MEDICAL GROUP
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 2972 WILSHIRE BLVD LOS ANGELES, CA 90010
- Location Phone
- (213) 484-0000
- Location Fax
- (213) 387-0011
- Mailing Address
- 2972 WILSHIRE BLVD LOS ANGELES, CA 90010
- Mailing Phone
- (213) 484-0000
- Mailing Fax
- (213) 387-0011
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-31-2007
- Last Update Date
- 10-28-2015
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- A48731
- License State
- CA
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| GR0055560 | MEDICAID (05) | CA | |
| W13920 | MEDICARE ID-TYPE UNSPECIFIED (04) | CA | MEDICARE GROUP PROVIDER |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D0894038
- Facility Type
- Community Clinic
- Certificate Effective Date
- June 14, 2024
- Certificate Expiration Date
- June 13, 2026
- Laboratory Director
- NEJAT ROSTAMI MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to San Judas Medical Group to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1609913441, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 69 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1609913441, enumerated as an "organization" on January 31, 2007.
The provider is located at 2972 WILSHIRE BLVD LOS ANGELES, CA 90010 and the phone number is (213) 484-0000.
Specialist with taxonomy code 174400000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
