{"npi":"1568649226","type":"NPI-2","status":"active","name":{"display":"Uptimum Medical Group And Ipa INC","other":[],"organization_name":"UPTIMUM MEDICAL GROUP AND IPA INC","authorised_official":"Olukemi Wallace"},"specialty":{"primary_taxonomy":"174400000X","primary_taxonomy_description":"Specialist","slug":"specialist","schema_org_specialty":null,"all":[{"code":"174400000X","description":"Specialist","primary":true,"state":"CA","license":"A48240"}]},"addresses":[{"purpose":"LOCATION","street_1":"2220 W MANCHESTER BLVD","city":"INGLEWOOD","state":"CA","postal_code":"903052514","country_code":"US","phone":"3106448400"},{"purpose":"MAILING","street_1":"15342 HAWTHORNE BLVD STE 102","city":"LAWNDALE","state":"CA","postal_code":"902602181","country_code":"US","phone":"3106448400","fax":"3106448424"}],"license":{"state":"CA","number":"A48240"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"8831128","state":"CA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20170627001859","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"CA","pac_id":"4183993637"},{"enrlmt_id":"O20180112001264","type_code":"30-90","type_desc":"DME SUPPLIER - PHYSICIAN - MEDICAL ONCOLOGY","state":"CA","pac_id":"4183993637"}]},"enumeration_date":"2008-01-24","last_updated":"2024-10-08","_meta":{"source":"NPPES","snapshot_date":"2024-10-08","doc_url":"https://findmynpi.com/api"}}