Mission San Juan Medical Clinic

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A93526 Issued in CA

Legal business name

MISSION SAN JUAN MEDICAL CLINIC

Practice address

9914 San Juan Ave
South Gate, CA 90280-6108

Phone

(323) 564-1100

NPI assigned

Jul 2, 2008

Last updated

Jul 2, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Noel Jr Torres, MD

Title

Medical Director

Phone

(323) 564-1100

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1023271830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9914 SAN JUAN AVE",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806108",
            "telephone_number": "323-564-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9914 SAN JUAN AVE",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806108",
            "telephone_number": "323-564-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION SAN JUAN MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "NOEL",
        "authorized_official_middle_name": "JR",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "323-564-1100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A93526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL LICENSE",
            "identifier": "A93526",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mi Young Han (Imperial Dental Ctr)
• Mia Larissa Ancheta, DDS, a Dental Corporation (Mars Dental Group)
• Millot DDS Inc (Seville Dental Group)
• Antemio Millot, D.D.S.
• Jesse Miramontes, RAC
• Mitsuo Yanagihara, D.C., Inc.
• Roy Miyamoto, DDS
• Nitin Ochhavlal Mody, DDS
• Alicia Danielle Monazzam, NP
• Jafar Mottaghian Monazzam, PT

• General Practice Physician in South Gate, CA
• Providers in South Gate, 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 Jul 2, 2008; 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.