Advanced Medical Group, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C55850 Issued in CA

Legal business name

ADVANCED MEDICAL GROUP, INC

Practice address

510 N Prospect Ave
Ste 306
Redondo Beach, CA 90277-3028

Phone

(310) 376-7555

NPI assigned

Jun 2, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Eskarous, DPM

Title

Secretary

Phone

60821328363

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1003296369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 N PROSPECT AVE",
            "address_2": "STE 306",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N PROSPECT AVE",
            "address_2": "STE 306",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773028",
            "telephone_number": "310-376-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "ESKAROUS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "60821328363",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C55850",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4996",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.