Las Palmas Medical Group Corp.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

G57022 Issued in CA

Legal business name

LAS PALMAS MEDICAL GROUP CORP.

Practice address

602 N Euclid Ave
Suite a
Ontario, CA 91762-3224

Phone

(909) 391-3448

NPI assigned

Feb 18, 2011

Organization subpart

No

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

Authorized official

Name

Irma Lopez, M.D.

Title

Owner

Phone

(909) 391-3448

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Las Palmas Medical Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Las Palmas Medical Group

  • General Practice Physician
  • Escondido, CA
  • NPI 1063718930
  NPD tax ID
• Las Palmas Medical Group

  • General Practice Physician
  • Hemet, CA
  • NPI 1164503652
  NPD tax ID

Locations

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

{
    "created_epoch": "1297987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297987200000",
    "number": "1013214568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 N EUCLID AVE",
            "address_2": "SUITE A",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917623224",
            "telephone_number": "909-391-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 N EUCLID AVE",
            "address_2": "SUITE A",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917623224",
            "telephone_number": "909-391-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS PALMAS MEDICAL GROUP CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-18",
        "last_updated": "2011-02-18",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "IRMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-391-3448",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "G57022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770663551",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164503652",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rafael Larios, PAC
• Justin Larkin
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• Rhonda Lassalle
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• Khan Lau, O.D.
• Lavender Mood Family Counseling Inc

• General Practice Physician in Ontario, CA
• Providers in Ontario, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2011; 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.