Integrative Medical Group, Inc., a Professional Corporation

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

INTEGRATIVE MEDICAL GROUP, INC., A PROFESSIONAL CORPORATION

Practice address

2200 W 3Rd St Ste 120a
Los Angeles, CA 90057-5901

Phone

(310) 905-3331

NPI assigned

May 17, 2016

Organization subpart

No

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

Authorized official

Name

Ryan Spivak, M.D.

Title

President

Phone

(310) 905-3331

Specialties & licenses 1

Addresses

Tax ID family

Integrative 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.

• Integrative Medical Group, Inc

  • Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
  • NPI 1003369380
  NPD tax ID

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463443200000",
    "number": "1013364397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 W 3RD ST STE 120A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900575901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W 3RD ST STE 120A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900575901",
            "telephone_number": "310-905-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE MEDICAL GROUP, INC., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-17",
        "last_updated": "2016-05-17",
        "status": "A",
        "authorized_official_last_name": "SPIVAK",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-905-3331",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrative Endodontics, Inc
• Integrative Lifecare
• Integrative Lifecare Acupuncture, Inc.
• Integrative Medical Associates Inc
• Integrative Medical Group, Inc
• Integrative Occupational Therapy Inc
• Integrative Surgical Associates Group, LLC.
• Integrity Health and Nursing of California, PC
• Integrity Treatment Program, LLC
• Intelligent Home Health Care, Inc.

• Plastic Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; 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.