OrganizationActive
St Nicholas Medical Group
NPI 1982808622 · Family Medicine Physician · Los Angeles, CA
Provider details
- NPI number
- 1982808622
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Lorenzo Tizon, Medical Director(323) 860-9054
- License
- A40329 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5520 Santa Monica Blvd
Suite 112
Los Angeles, CA 90038-2932
Phone: (323) 860-9054
Fax: (323) 860-9053
Street-level locationGet directions
Mailing address
5520 Santa Monica Blvd
Los Angeles, CA 90038
Registry dates
- Enumerated
- 2007-06-14
- Last updated
- 2010-02-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.