NPIMap

Organization Active NPI

Medixpartners.Com, a Professional Medical Corporation

  • Primary Care Clinic/Center
  • San Diego, CA
National Provider Identifier
1023317799
Registry record updated Mar 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
A36884 Issued in CA
Legal business name
MEDIXPARTNERS.COM, A PROFESSIONAL MEDICAL CORPORATION
Doing business as
Viva Wellness Medical Group
Practice address
3740 Rosecrans St
Suite C
San Diego, CA 92110-3126
Phone
(619) 222-5433
NPI assigned
Mar 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2011

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

Authorized official

Name
Eugene Michael Tachuk, MDNPI 1417330432
Title
President
Phone
(619) 222-5433

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
Primary Care Clinic/Center 261QP2300X A36884 CA Primary

Addresses

Primary practice location

3740 Rosecrans St
Suite C
San Diego, CA 92110-3126

Mailing address

3740 Rosecrans St
Suite C
San Diego, CA 92110-3126
Phone (619) 222-5433

Other names 1

  • Viva Wellness Medical Group Doing business as

National Provider Directory

National Provider Directory

Locations

3740 Rosecrans St
Ste C
San Diego, CA 92110
Phone (619) 222-5433

Practitioners & affiliated clinicians

Practitioners 1

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": "1300665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300665600000",
    "number": "1023317799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 ROSECRANS ST",
            "address_2": "SUITE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103126",
            "telephone_number": "619-222-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 ROSECRANS ST",
            "address_2": "SUITE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103126",
            "telephone_number": "619-222-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIXPARTNERS.COM, A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-21",
        "last_updated": "2011-03-21",
        "status": "A",
        "authorized_official_last_name": "TACHUK",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-222-5433",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A36884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Viva Wellness Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.