Minuteclinic Diagnostic Medical Group of California Inc
Organization Active NPI Family Nurse Practitioner · Burbank, CA
NPI 1033309372 · NPPES record last updated Oct 11, 2024
Key facts
- NPI
- 1033309372
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- Legal business name
- MINUTECLINIC DIAGNOSTIC MEDICAL GROUP OF CALIFORNIA INC
- Practice address
- 511 N Hollywood Way
Burbank, CA 91505-3406 - Phone
- (866) 389-2727
- Fax
- (401) 406-3539
- NPI assigned
- Aug 1, 2007
- Organization subpart
- No
Authorized official
- Name
- Deborah Pincince
- Title
- Administrator
- Phone
- (401) 770-3813
Corporate family (same tax ID) 2
Practitioners 245
-
Maribelle B. Abergas, FNP
-
Angie Lea-Wilson, FNP-C
-
Johnny Pham, FNP
-
Julius Timothy Yorac, RN, FNP-C
-
Jessica Marie Gallagher, NP-C
-
Arlette F Owens-Mosley, FNP-C, PMHNP-BC
-
Sherry Jung, NP
-
Emelia Mardigian, RN
-
Iris Roberts, NP
-
Shauntavia Ward, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090115000289 | CA | Part B Supplier - Clinic/Group Practice | 8224191374 |
Receives reassigned benefits from 230 practitioners Practice locations: San Francisco, CA; Walnut Creek, CA; Torrance, CA; Sherman Oaks, CA; San Jose, CA; San Bruno, CA; Reseda, CA; Sacramento, CA… |
National Provider Directory
- Tax ID family
- Minuteclinic Diagnostic Medical Group of California Inc
Locations
1401 S Baldwin Ave
Arcadia, CA 91007
Phone (626) 321-4210
1720 S Bascom Ave
Campbell, CA 95008
Phone (408) 371-7191
220 E Compton Blvd
Compton, CA 90220
Phone (310) 604-1747
10455 S De Anza Blvd
Cupertino, CA 95014
Phone (408) 996-1911
300 S Diamond Bar Blvd
Diamond Bar, CA 91765
Phone (909) 861-5551
2315 Huntington Dr
Duarte, CA 91010
Phone (626) 305-9333
5040 Laguna Blvd
Elk Grove, CA 95758
Phone (916) 684-6822
8101 Greenback Ln
Fair Oaks, CA 95628
Phone (916) 726-4433
1122 E Broadway
Glendale, CA 91205
Phone (818) 279-3974
2900 N Sepulveda Blvd
Manhattan Beach, CA 90266
Phone 3105463481 ext. 8221
45 N Milpitas Blvd
Milpitas, CA 95035
Phone (408) 946-6424
16995 Walnut Grove Dr
Morgan Hill, CA 95037
Phone (408) 779-6981
2085 Fair Oaks Blvd
Sacramento, CA 95825
Phone (916) 929-9577
470 Blossom Hill Rd
San Jose, CA 95123
Phone (408) 578-4900
2700 Homestead Rd
Santa Clara, CA 95051
Phone (408) 247-8700
2505 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 828-6456
576 E El Camino Real
Sunnyvale, CA 94087
Phone (408) 739-4620
8491 Santa Monica Blvd
West Hollywood, CA 90069
Phone (310) 360-7303
23357 Mulholland Dr
Woodland Hills, CA 91364
Phone (818) 223-8240
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | |||
| Clinical Social Worker |
1041C0700X | |||
| Marriage & Family Therapist |
106H00000X | |||
| Family Nurse Practitioner |
363LF0000X | Yes |
Addresses
Primary practice location
511 N Hollywood Way
Burbank, CA 91505-3406
Mailing address
PO Box 772
Payor Enrollment-MC 2295
Woonsocket, RI 02895-0784
Phone (866) 389-2727
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DO3845 | Other | CA | MEDICARE RAILROAD |
Other providers in Burbank, CA
- Diana Minasyan
- Mind and Help Home Health, Inc.
- Mindbloom ABA Therapy Corporation
- Elizabeth Minor
- Maria Ruby R Minosa
- Minuteclinic Diagnostic Medical Group of California Inc
- Minuteclinic Diagnostic Medical Group of California Inc
- Mir Ali-Khan M D Professional Corporation
- Barry Mir-Motahari
- Marina Mirabal
All providers in Burbank, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.