Healthcare Provider Details

I. General information

NPI: 1588868640
Provider Name (Legal Business Name): HP COMMUNITY CARE MEDICAL ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 PACIFIC BLVD
HUNTINGTON PARK CA
90255-2537
US

IV. Provider business mailing address

PO BOX 2910
PALOS VERDES PENINSULA CA
90274-8910
US

V. Phone/Fax

Practice location:
  • Phone: 323-585-8777
  • Fax: 323-585-8889
Mailing address:
  • Phone: 323-585-8777
  • Fax: 323-585-8889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA053317
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA053317
License Number StateCA

VIII. Authorized Official

Name: DR. AUGUSTINE ILUORE
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 323-585-8777