Organization Active NPI

Pacific Neuro Diagnostic Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Palmdale, CA
National Provider Identifier
1073712790
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
PACIFIC NEURO DIAGNOSTIC MEDICAL GROUP, INC.
Practice address
2361B E Palmdale Blvd
Palmdale, CA 93550-4910
Phone
(661) 540-0824
NPI assigned
Jul 12, 2007
Last updated
Jul 12, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Authorized official

Name
Sim C. Hoffman, MDNPI 1053423079
Title
President
Phone
(661) 540-0824

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Chiropractor 111N00000X
Internal Medicine Physician 207R00000X
Neurological Surgery Physician 207T00000X
Orthopaedic Surgery Physician 207X00000X Primary
Physical Medicine & Rehabilitation Physician 208100000X
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X

Addresses

Primary practice location

2361B E Palmdale Blvd
Palmdale, CA 93550-4910

Mailing address

6800 Lincoln Ave
Suite 200
Buena Park, CA 90620-4162
Phone (714) 995-5400

National Provider Directory

National Provider Directory
Tax ID family
Pacific Neuro Diagnostic Medical Group Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2361 E Palmdale Blvd
Ste B
Palmdale, CA 93550
Phone (661) 540-0824

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184198400000",
    "number": "1073712790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 LINCOLN AVE",
            "address_2": "SUITE 200",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906204162",
            "telephone_number": "714-995-5400",
            "fax_number": "714-995-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2361B E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504910",
            "telephone_number": "661-540-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC NEURO DIAGNOSTIC MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-12",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "SIM",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-540-0824",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.