MEDICARE: IMMANUEL MEDICAL CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1912107202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMMANUEL MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	903 CRENSHAW BLVD STE 302
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-1967
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	903 CRENSHAW BLVD STE 302
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-1967
Country	:	US
Telephone Number	:	323-931-8866
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CLYDE ARNOLD
Credential	:
Telephone Number	:	323-931-8866

Provider Enumeration Date	:	07/24/2007
Last Update Date	:	07/24/2007

Similar Medicare Providers

1407131279 — YOUNGSOOK LEE HAN ACUPUNCTURIST
Practice Location Address:

903 CRENSHAW BLVD STE 302
LOS ANGELES, CA
90019-1967

Practice Phone: 323-938-1000
Practice Fax:

1972607364 — DR. YONG TAI LEE M.D.
Practice Location Address:

903 CRENSHAW BLVD STE 302
LOS ANGELES, CA
90019-1967

Practice Phone: 323-731-0681
Practice Fax: 323-731-0832

1033315155 — JAMIE H. YANG
Practice Location Address:

903 CRENSHAW BLVD STE 304
LOS ANGELES, CA
90019-1967

Practice Phone: 213-284-4290
Practice Fax:

1285805002 — MR. SUNG HO CHIN OTR/L
Practice Location Address:

903 CRENSHAW BLVD , STE 301
LOS ANGELES, CA
90019-1967

Practice Phone: 626-375-0855
Practice Fax:

1811152846 — JULIE MYUNG PARK
Practice Location Address:

903 CRENSHAW BLVD STE 301
LOS ANGELES, CA
90019-1967

Practice Phone: 323-938-6460
Practice Fax:

1417194663 — IN JOON CHUNG LAC, OMD
Practice Location Address:

903 CRENSHAW BLVD STE 302
LOS ANGELES, CA
90019-1967

Practice Phone: 323-938-1000
Practice Fax: 323-938-6642

Directions to “IMMANUEL MEDICAL CENTER INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.