Platinum Medical Group, Inc.

Primary specialty

ContractorTaxonomy code 171W00000X

Legal business name

PLATINUM MEDICAL GROUP, INC.

Practice address

21520 Pioneer Blvd Ste 203
Hawaiian Gardens, CA 90716-2601

Phone

(562) 402-2818

Fax

(800) 373-9195

NPI assigned

Jun 22, 2011

Organization subpart

No

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

Authorized official

Name

Paul Randall

Title

Chief Executive Officer

Phone

(562) 402-2818

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308700800000",
    "number": "1063708675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21520 PIONEER BLVD STE 203",
            "city": "HAWAIIAN GARDENS",
            "state": "CA",
            "postal_code": "907162601",
            "telephone_number": "562-402-2818",
            "fax_number": "800-373-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21520 PIONEER BLVD STE 203",
            "city": "HAWAIIAN GARDENS",
            "state": "CA",
            "postal_code": "907162601",
            "telephone_number": "562-402-2818",
            "fax_number": "800-373-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATINUM MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-06-22",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "562-402-2818"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Perez
• Christine Michelle Periman, LAADC- CA, CATC IV
• Sonita Persaud, M.S., CCC-SLP
• Fengji Piao
• Platinum Medical Group
• Platinum Medical Management, Inc.
• Prime Link Medical Specialty Group Inc.
• Prohealth Partners a Medical Group Inc
• June Puthasombat, MSW
• Vanisha Noami Quevedo

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; 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.