Legacy Medical Group, Inc.

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

LEGACY MEDICAL GROUP, INC.

Practice address

292 Euclid Ave Ste 210
San Diego, CA 92114-3629

Phone

(619) 262-2224

NPI assigned

Jan 23, 2018

Organization subpart

No

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

Authorized official

Name

Ralph Hernandez

Title

Executive Director

Phone

(619) 733-5192

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519084800000",
    "number": "1083112247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 EUCLID AVE STE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921143629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 EUCLID AVE STE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921143629",
            "telephone_number": "619-262-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-23",
        "last_updated": "2018-02-20",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "619-733-5192"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Riebel Lefringhouse, M.D., M.P.H.
• Judi Lefter, RN
• Darreca Leftridge
• Legacy Care Adhc Corporation
• Legacy Home Health & Rehabilitation, LLC
• Legacy Medical Transportation LLC
• Daryl Legaspi, RN
• Donna Rose Legaspi, RN
• Gladys Macaoay Legaspi, MSN, APRN, FNP-C
• Joey Legaspi, IDC

• Multi-Specialty Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; 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.