Premier Healthcare Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G42472 Issued in CA

Legal business name

PREMIER HEALTHCARE MEDICAL GROUP

Practice address

8301 S Vermont Ave
Suite a
Los Angeles, CA 90044-3470

Phone

(323) 778-7772

Fax

(323) 789-2673

NPI assigned

Mar 13, 2009

Last updated

Mar 13, 2009By 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

Lorena Rodriguez

Title

Administrator

Phone

(323) 778-7772

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Gwenervere Louise Flagg, M.D.

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1548216674
  NPD (past)

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236902400000",
    "number": "1043451446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 S VERMONT AVE",
            "address_2": "SUITE A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900443470",
            "telephone_number": "323-778-7772",
            "fax_number": "323-789-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 S VERMONT AVE",
            "address_2": "SUITE A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900443470",
            "telephone_number": "323-778-7772",
            "fax_number": "323-789-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEALTHCARE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-13",
        "last_updated": "2009-03-13",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "LORENA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "323-778-7772"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G42472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Cardiology and Vascular Institute Inc (Hwanginyong ttatteutan simjangnaegwa)
• Premier Choice DME
• Premier Emergency Physicians of California Medical Group PC
• Premier Emergency Physicians of California Medical Group PC
• Premier Healthcare and Supplies
• Premier Hematology Oncology Medical Group Inc
• Premier Infusion and Healthcare Services, Inc.
• Premier Management Association
• Premier Marketing Resources Corp (Johnnies Ride, Personal Transportation Services)
• Premier Med Services Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.