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ST NICHOLAS MEDICAL GROUP
NPI 1891026100
Internal Medicine - Geriatric Medicine in Los Angeles, CA

Active since January 26, 2010
5520 SANTA MONICA BLVD, SUITE 112, LOS ANGELES, CA 90038(323) 860-9054(323) 860-9053 Get Directions Write a Review

NPPES record last updated: August 26, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About St Nicholas Medical Group NPPES

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

ST NICHOLAS MEDICAL GROUP (NPI 1891026100) is a healthcare organization registered as a geriatric medicine in Los Angeles, California and active in the NPI registry since January 2010. The organization lists Jacob N Flores, Partner, as its authorized official.

NPPES Registry Identity

NPI1891026100
Entity TypeOrganization
Primary Taxonomy207RG0300X
Legal Business NameST NICHOLAS MEDICAL GROUP
Location Address5520 SANTA MONICA BLVD, SUITE 112Los Angeles, CA 90038-2932
Mailing Address5520 Santa Monica Blvd, Suite 112Los Angeles, CA 90038-2932 · (323) 860-9054 · Fax (323) 860-9053
Phone(323) 860-9054
Fax(323) 860-9053
Organization SubpartNo
Authorized OfficialJacob N FloresPartner · (323) 860-9054
Enumeration DateJanuary 26, 2010
Last NPPES UpdateAugust 26, 2010
✔ NPI 1891026100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RG0300X
License✔ Licensed in CA · A60865
Definition
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.
5520 SANTA MONICA BLVD, Los Angeles, CA 90038
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Other Identifiers 1

Medicare PINCQ793CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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.

ST ANDREWS MEDICAL GROUP INC
Specialist
5520 SANTA MONICA BLVD, SUITE 112
LOS ANGELES, CA 90038
Los Angeles County (323) 860-9054
ST NICHOLAS MEDICAL GROUP
Family Medicine
5520 SANTA MONICA BLVD, SUITE 112
LOS ANGELES, CA 90038
Los Angeles County (323) 860-9054

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 St Nicholas Medical Group's NPI number?

The NPI number for St Nicholas Medical Group is 1891026100. It was assigned to this organization in the NPPES registry on January 26, 2010.

Where is St Nicholas Medical Group located?

St Nicholas Medical Group is located at 5520 Santa Monica Blvd Suite 112, Los Angeles, CA 90038. The listed phone number is (323) 860-9054.

What is St Nicholas Medical Group's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

When was this NPI record last updated?

The NPPES record for St Nicholas Medical Group was last updated on August 26, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.