Medcore HP

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

MEDCORE HP

Practice address

2701 E Hammer LN
Suite 103
Stockton, CA 95210-4245

Phone

(209) 320-2631

Fax

(209) 320-2653

NPI assigned

Mar 21, 2017

Organization subpart

Yes

Parent organization

OMNI IPA MEDICAL GROUP, INC.As reported in NPPES

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

Authorized official

Name

Mrs. Maria Teresa Martinez

Title

Chief Operations Officer

Phone

(209) 320-2631

Specialties & licenses 1

Addresses

Part of

Omni Ipa Medical Group Inc

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.

• Omni Ipa Medical Group, Inc.

  dba Omni IPA, Inc.

  • Health Maintenance Organization
  • Stockton, CA
  • NPI 1912115569
  NPPES parent name

Practitioners 2

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

• Madhusudan N Dharawat, M.D.

  • Cardiovascular Disease Physician
  • Stockton, CA
  • NPI 1376685065
  NPD (past)
• Harbhajan Singh Shergill, MD

  • General Practice Physician
  • Stockton, CA
  • NPI 1639187552
  NPD (past)

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490054400000",
    "number": "1063943223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 E HAMMER LANE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95210",
            "telephone_number": "209-320-2631",
            "fax_number": "209-320-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 E HAMMER LN",
            "address_2": "SUITE 103",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952104245",
            "telephone_number": "209-320-2631",
            "fax_number": "209-320-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCORE HP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OMNI IPA MEDICAL GROUP, INC.",
        "enumeration_date": "2017-03-21",
        "last_updated": "2017-03-21",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "TERESA",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "209-320-2631",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Andree Mead-Goyette, D.C.
• Jammonoy Meadows
• Zachary Meadows, L.AC.
• Christy Ann Mecham
• Medcare Transport SVCS
• Maddox Medeiros
• Amanda Medellin
• Janaiah Mediana
• Medical Anesthesia Services of Northern California, PC
• Medical Diagnostic Laboratories

• Specialist in Stockton, CA
• Providers in Stockton, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; 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.