Executive Medicine, Inc.

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

EXECUTIVE MEDICINE, INC.

Practice address

1227 Buena Vista St Ste F
Duarte, CA 91010-2486

Phone

(877) 254-4496

Fax

(877) 254-4496

NPI assigned

Apr 26, 2024

Organization subpart

Yes

Parent organization

EXECUTIVE MEDICINE, INC.As reported in NPPES

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

Authorized official

Name

Ulin Sargeant, MD

Title

President

Phone

(877) 254-4496

Specialties & licenses 1

Addresses

Other names 1

• Monrovia Internal Medicine and Primary Care Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Executive Medicine, Inc.

  • Internal Medicine Physician
  • Duarte, CA
  • NPI 1407291347

  O20150610000175

  Same enrollment

Part of

Executive Medicine Inc

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Executive Medicine, Inc.

  • Internal Medicine Physician
  • Duarte, CA
  • NPI 1407291347
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Xuan Hao Thi Doan, PA

  • Medical Physician Assistant
  • Torrance, CA
  • NPI 1831802578
  NPD
• Summer Denaye Gonzales, PA

  • Physician Assistant
  • Oakland, CA
  • NPI 1245979756
  NPD

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

{
    "created_epoch": "1714089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714089600000",
    "number": "1033965413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2063",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910176063",
            "telephone_number": "877-254-4496",
            "fax_number": "877-254-4496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 BUENA VISTA ST STE F",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910102486",
            "telephone_number": "877-254-4496",
            "fax_number": "877-254-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE MEDICINE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXECUTIVE MEDICINE, INC.",
        "enumeration_date": "2024-04-26",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A",
        "authorized_official_last_name": "SARGEANT",
        "authorized_official_first_name": "ULIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "877-254-4496",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monrovia Internal Medicine and Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deanna Erwin, MS
• Holly Ann-Marie Escalera, AMFT
• Mark Esensten, MD
• Carin Espenschied, MS, CGC
• Evelinda Gene N Evangelista
• Executive Medicine, Inc.
• Maeva Martina Fabila
• Mildred Gabot Fabros, PA-C
• Bridget N. Fahy-Chandon, M.D.
• Marwan G Fakih, MD

• Urgent Care Clinic/Center in Duarte, CA
• Providers in Duarte, CA by specialty
• Urgent Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.