Provider Demographics
NPI:1588868640
Name:HP COMMUNITY CARE MEDICAL ASSOCIATES INC
Entity type:Organization
Organization Name:HP COMMUNITY CARE MEDICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ILUORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-585-8777
Mailing Address - Street 1:PO BOX 2910
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES PENINSULA
Mailing Address - State:CA
Mailing Address - Zip Code:90274-8910
Mailing Address - Country:US
Mailing Address - Phone:323-585-8777
Mailing Address - Fax:323-585-8889
Practice Address - Street 1:5600 PACIFIC BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-2537
Practice Address - Country:US
Practice Address - Phone:323-585-8777
Practice Address - Fax:323-585-8889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA053317207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0095490Medicaid