Pacific Vistas Telehealth Inc.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

PACIFIC VISTAS TELEHEALTH INC.

Practice address

530 West Graves
Monterey Park, CA 91754

Phone

(917) 653-4625

Fax

(517) 212-9671

NPI assigned

Nov 7, 2022

Organization subpart

No

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

Authorized official

Name

Jeremy D. Williams MD, MD

Title

President

Phone

(917) 653-4625

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667779200000",
    "number": "1013625391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 WELLINGTON ROAD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90016",
            "telephone_number": "917-653-4625",
            "fax_number": "517-212-9671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 WEST GRAVES",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "91754",
            "telephone_number": "917-653-4625",
            "fax_number": "517-212-9671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC VISTAS TELEHEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS MD",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-653-4625",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corina Orozco
• Jacquelyn Ortiz Ramirez, ASW
• Savannah Alexis Ortiz
• Pacific Alliance Medical Group
• Pacific Shores Medical Group, Inc.
• Sara Marie Padilla
• Ruth Paez, PHYSICIAN ASSISTANT
• Palomino Residential Care Inc.
• Palomino Residential Care Inc.
• Palomino Residential Care Inc.

• Emergency Medicine Physician in Monterey Park, CA
• Providers in Monterey Park, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.