Pathway Medical Group

Primary specialty

SpecialistTaxonomy code 174400000X

License

A42016 Issued in CA

Legal business name

PATHWAY MEDICAL GROUP

Practice address

21500 S. Pioneer Blve Suite 210
Hawaiian Gardens, CA 90716

Phone

(562) 360-1556

Fax

(562) 786-8629

NPI assigned

Apr 16, 2015

Organization subpart

No

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

Authorized official

Name

Gary Phillip Jacobs, MD

Title

Owner/Doctor

Phone

(562) 360-1556

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1429142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429142400000",
    "number": "1053708081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21500 S. PIONEER BLVE SUITE 210",
            "city": "HAWAIIAN GARDENS",
            "state": "CA",
            "postal_code": "90716",
            "telephone_number": "562-360-1556",
            "fax_number": "562-786-8629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21500 S. PIONEER BLVE SUITE 210",
            "city": "HAWAIIAN GARDENS",
            "state": "CA",
            "postal_code": "90716",
            "telephone_number": "562-360-1556",
            "fax_number": "562-786-8629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-16",
        "last_updated": "2015-04-16",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "562-360-1556",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A42016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Gardens Medical Center, LLC
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• Allison Palacios
• Yuna Park
• Esmeralda Peralta
• Isamarc Perez, PPSC
• Nancy Perez
• Christine Michelle Periman, LAADC- CA, CATC IV
• Sonita Persaud, M.S., CCC-SLP

• Specialist in Hawaiian Gardens, CA
• Providers in Hawaiian Gardens, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; 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.