La Guadalupana Medical Group a Medical Corporation

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

License

A66385 Issued in CA

Legal business name

LA GUADALUPANA MEDICAL GROUP A MEDICAL CORPORATION

Practice address

307 E 1St St
1C
Santa Ana, CA 92701-5302

Phone

(714) 839-8676

Fax

(714) 839-8675

NPI assigned

Sep 2, 2015

Organization subpart

Yes

Parent organization

UROGYNECOLOGY ASSOCIATES A MEDICAL CORPORATIONAs reported in NPPES

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

Authorized official

Name

Dr. Aram Bonni, M.D.

Title

Medical Director/Owner

Phone

(714) 839-8676

Specialties & licenses 2

Addresses

Other identifiers 2

Part of

Urogynecology Associates a Medical Corporation

Locations

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.

• Urogynecology Associates, a Medical Corporation

  • Gynecology Physician
  • Los Angeles, CA
  • NPI 1770736456
  NPPES parent name

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441152000000",
    "number": "1053788471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 E 1ST ST",
            "address_2": "1C",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927015302",
            "telephone_number": "714-839-8676",
            "fax_number": "714-839-8675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E 1ST ST",
            "address_2": "1C",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927015302",
            "telephone_number": "714-839-8676",
            "fax_number": "714-839-8675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA GUADALUPANA MEDICAL GROUP A MEDICAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UROGYNECOLOGY ASSOCIATES A MEDICAL CORPORATION",
        "enumeration_date": "2015-09-02",
        "last_updated": "2015-09-02",
        "status": "A",
        "authorized_official_last_name": "BONNI",
        "authorized_official_first_name": "ARAM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "714-839-8676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medical Technician, Basic",
            "state": "CA",
            "license": "A66385",
            "primary": true
        },
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": "CA",
            "license": "A66385",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11404859164",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA MEDICAL LICENSE",
            "identifier": "A66385",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Tammy La
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• Basic Emergency Medical Technician in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Basic Emergency Medical Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.