# ARDMORE MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clinica Humanitaria
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427140136
- **Authorized official:** ALAN R KIMS MD (PRESIDENT MD)
- **Authorized official phone:** (323) 562-6170

## Contact information

- **Practice address:** 3518 W 8TH STREET, LOS ANGELES, CA 90005
- **Practice address phone:** (213) 384-9949
- **Practice address fax:** (213) 384-2530
- **Mailing address:** 5953 ATLANTIC BLVD, MAYWOOD, CA 90270
- **Mailing address phone:** (323) 562-6170
- **Mailing address fax:** (323) 562-6176

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 457622 | CA | Yes |

## Other

- **Enumeration date:** 09/29/2006
- **Last updated:** 08/22/2020