Vista Medical Partners a Professional Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

VISTA MEDICAL PARTNERS A PROFESSIONAL CORPORATION

Practice address

2105 Beverly Blvd Ste 231
Los Angeles, CA 90057-2287

Phone

(310) 288-5933

Fax

(866) 683-4556

NPI assigned

Jan 25, 2007

Last updated

Aug 24, 2021By 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

David A McDonough, MDNPI 1295866341

Title

President/Sole Owner

Phone

(310) 288-5933

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David A McDonough, M.D.

  • Internal Medicine Physician
  • Tustin, CA
  • NPI 1295866341
  Medicare reassignment Authorized official
• Kathy Marie Van Stone, PSY.D

  • Clinical Psychologist
  • Cedar Park, TX
  • NPI 1467583419
  NPD
• William Benjamin Flores, P.A.

  • Physician Assistant
  • Beverly Hills, CA
  • NPI 1942530571
  NPD (past)
• Audrey Khatchikian, PHD

  • Clinical Neuropsychologist
  • Glendale, CA
  • NPI 1780775742
  NPD (past)
• Sara Marie Maya, FNP, MPH

  • Family Nurse Practitioner
  • Sacramento, CA
  • NPI 1669613378
  NPD (past)
• Jagadeesh C Reddy, M.D.

  • Infectious Disease Physician
  • Laguna Beach, CA
  • NPI 1083610703

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1043366164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 BEVERLY BLVD STE 231",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572287",
            "telephone_number": "310-288-5933",
            "fax_number": "866-683-4556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 BEVERLY BLVD STE 231",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572287",
            "telephone_number": "310-288-5933",
            "fax_number": "866-683-4556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA MEDICAL PARTNERS A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "MCDONOUGH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/SOLE OWNER",
        "authorized_official_telephone_number": "310-288-5933",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G730431",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vista del Sol Health Services Inc
• Vista del Sol Health Services Inc (Casa del Mar IV - Residence)
• Vista del Sol Health Services Inc (Casa del Mar III - Residence)
• Vista del Sol Health Services Inc (Casa del Mar - Residence)
• Vista del Sol LTC, Inc. (Vista Del Sol Care Center)
• Vista West Health Center LP (Vista West Health Center)
• Gillian Amber Vista
• Josefina Billedo Viste, MD
• Vistiting Physicians Associates LLC
• Anette Paulina Vistoso Monreal

• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.