NPIMap

Organization Active NPI

Healthcare Providers of California Medical Group, Inc

  • Internal Medicine Physician
  • San Ysidro, CA
National Provider Identifier
1003846486
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A51621 Issued in CA
Legal business name
HEALTHCARE PROVIDERS OF CALIFORNIA MEDICAL GROUP, INC
Practice address
342 W San Ysidro Blvd
#F
San Ysidro, CA 92173-2495
Phone
(619) 662-3880
Fax
(619) 662-2942
NPI assigned
Jul 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Edward John Giaquinto Jr., PH.D.NPI 1992756977
Title
President
Phone
(818) 421-2799

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A51621 CA Primary

Addresses

Primary practice location

342 W San Ysidro Blvd
#F
San Ysidro, CA 92173-2495

Mailing address

24425 Woolsey Canyon Rd
#11
Canoga Park, CA 91304-1131
Phone (818) 713-1115

National Provider Directory

National Provider Directory
Tax ID family
Healthcare Providers of California Medical Group Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

342 W San Ysidro Blvd
Ste F
San Ysidro, CA 92173
Phone (619) 662-3880

14602 Victory Blvd
Ste 125
Van Nuys, CA 91411
Phone (818) 988-6885

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003846486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24425 WOOLSEY CANYON RD",
            "address_2": "#11",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913041131",
            "telephone_number": "818-713-1115",
            "fax_number": "818-713-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 W SAN YSIDRO BLVD",
            "address_2": "#F",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921732495",
            "telephone_number": "619-662-3880",
            "fax_number": "619-662-2942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHCARE PROVIDERS OF CALIFORNIA MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GIAQUINTO",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-421-2799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A51621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ysidro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.