NPIMap

Organization Active NPI

Garrison Family Medical Group Canyon Country

  • Specialist
  • Palmdale, CA
National Provider Identifier
1043449192
Registry record updated Jul 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G50780 Issued in CA
Legal business name
GARRISON FAMILY MEDICAL GROUP CANYON COUNTRY
Practice address
41210 11TH St W
Suite C
Palmdale, CA 93551-1447
Phone
(661) 947-7100
Fax
(661) 947-5151
NPI assigned
Jul 10, 2009
Organization subpart
Yes
Parent organization
GARRISON FAMILY MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 10, 2009

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

Authorized official

Name
Mrs. Antonette Abatti
Title
Business Administrator
Phone
(661) 947-7100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X G50780 CA Primary

Addresses

Primary practice location

41210 11TH St W
Suite C
Palmdale, CA 93551-1447

Mailing address

41210 11TH St W
Suite C
Palmdale, CA 93551-1447
Phone (661) 947-7100

National Provider Directory

National Provider Directory
Tax ID family
Garrison Family Medical Group Canyon Country4 organizations share this tax ID, including this one
Part of
Garrison Family Medical Group Canyon Country

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

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": "1247184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247184000000",
    "number": "1043449192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41210 11TH ST W",
            "address_2": "SUITE C",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511447",
            "telephone_number": "661-947-7100",
            "fax_number": "661-947-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41210 11TH ST W",
            "address_2": "SUITE C",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511447",
            "telephone_number": "661-947-7100",
            "fax_number": "661-947-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARRISON FAMILY MEDICAL GROUP CANYON COUNTRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GARRISON FAMILY MEDICAL GROUP",
        "enumeration_date": "2009-07-10",
        "last_updated": "2009-07-10",
        "status": "A",
        "authorized_official_last_name": "ABATTI",
        "authorized_official_first_name": "ANTONETTE",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "661-947-7100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G50780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; 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.