Indiana First Medical Group Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A048560 Issued in CA

Legal business name

INDIANA FIRST MEDICAL GROUP INC

Practice address

4082 Whittier Blvd Ste 103
Los Angeles, CA 90023-2559

Phone

(323) 268-5598

Fax

(323) 268-8892

NPI assigned

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Pei Hsin Chao, M.D.NPI 1871636464

Title

Owner

Phone

(323) 268-5598

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• INDIANA FIRST MEDICAL GROUP Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pei H. Chao, M.D.

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1871636464
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1063591584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900630202",
            "telephone_number": "323-268-5598",
            "fax_number": "323-268-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4082 WHITTIER BLVD STE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900232559",
            "telephone_number": "323-268-5598",
            "fax_number": "323-268-8892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA FIRST MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A",
        "authorized_official_last_name": "CHAO",
        "authorized_official_first_name": "PEI",
        "authorized_official_middle_name": "HSIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-268-5598",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A048560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ81352Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INDIANA FIRST MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.