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STACY MEDICAL CENTER
NPI 1861830648
General Practice in Vernon, CA

Active since June 13, 2013CLIA 05D2210233 · Waiver
4580 PACIFIC BLVD, VERNON, CA 90058(323) 584-0779(323) 584-2282 Get Directions Write a Review

NPPES record last updated: June 13, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Stacy Medical Center NPPES

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

STACY MEDICAL CENTER (NPI 1861830648) is a healthcare organization registered as a general practice in Vernon, California and active in the NPI registry since June 2013. The organization holds a CLIA Waiver certificate valid through January 19, 2027 and lists Steven Harlan Florman, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1861830648
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameSTACY MEDICAL CENTER
Location Address4580 PACIFIC BLVDVernon, CA 90058-2208
Mailing Address4580 Pacific BlvdVernon, CA 90058-2208 · (323) 584-0779 · Fax (323) 584-2282
Phone(323) 584-0779
Fax(323) 584-2282
Organization SubpartNo
Authorized OfficialSteven Harlan FlormanMedical Director · (323) 584-0779
Enumeration DateJune 13, 2013
✔ NPI 1861830648 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
4580 PACIFIC BLVD, Vernon, CA 90058
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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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2210233

Stacy Medical Center, Inc · Vernon, CA
Active · expires Jan 19, 2027
CLIA Number05D2210233
Laboratory TypePractitioner Other
Certificate Effective DateJanuary 20, 2025
Certificate Expiration DateJanuary 19, 2027
Laboratory DirectorPaul Seung Kim
Laboratory Phone(323) 584-0779
Laboratory LocationStacy Medical Center, Inc4580 Pacific Blvd, Vernon, CA 90058
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

CONNETT BREWER PA-C
Physician Assistant
4580 PACIFIC BLVD
VERNON, CA 90058
Los Angeles County (323) 584-0779
STEVEN FLORMAN MD
Pain Medicine (Interventional Pain Medicine)
4580 PACIFIC BLVD
VERNON, CA 90058
Los Angeles County (323) 584-0779
ERICA WATTS PA-C
Physician Assistant
4580 PACIFIC BLVD
VERNON, CA 90058
Los Angeles County (323) 584-0779

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 Stacy Medical Center's NPI number?

The NPI number for Stacy Medical Center is 1861830648. It was assigned to this organization in the NPPES registry on June 13, 2013.

Where is Stacy Medical Center located?

Stacy Medical Center is located at 4580 Pacific Blvd, Vernon, CA 90058. The listed phone number is (323) 584-0779.

What is Stacy Medical Center's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Stacy Medical Center hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2210233) is associated with this NPI, valid through January 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Stacy Medical Center was last updated on June 13, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.