# ST. JOHNS URGENT CARE & MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST .JOHN URGENT CARE & MEDICAL CORPORATION
- **Other names:** none
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1023524980
- **Legal business name:** ST .JOHN URGENT CARE & MEDICAL CORPORATION
- **Authorized official:** MIKE MANSOUR ROSTAMI M.D (MEDICAL DIRECTOR/ OWNER)
- **Authorized official phone:** (323) 957-9300

## Contact information

- **Practice address:** 1138 N WESTERN AVE, LOS ANGELES, CA 90029-1702
- **Practice address phone:** (323) 957-9300
- **Practice address fax:** (323) 957-9315
- **Mailing address:** 1138 NORTH WESTERN AVE, LOS ANGELES, CA 90029-1702
- **Mailing address phone:** (323) 957-9300
- **Mailing address fax:** (323) 957-9315

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A50108 | CA | Yes |

## Other

- **Enumeration date:** 12/14/2017
- **Last updated:** 12/20/2017