Clinica del Pueblo Medical Group Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A056363 Issued in CA

Legal business name

CLINICA DEL PUEBLO MEDICAL GROUP CORP

Practice address

10200 Main St Ste B
Lamont, CA 93241-1700

Phone

(661) 845-1788

Fax

(661) 845-1791

NPI assigned

Nov 6, 2010

Last updated

Nov 6, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sam N Ratnayake, MD

Title

Director

Phone

(661) 377-3777

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1289001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289001600000",
    "number": "1104127109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 MAIN ST STE B",
            "city": "LAMONT",
            "state": "CA",
            "postal_code": "932411700",
            "telephone_number": "661-845-1788",
            "fax_number": "661-845-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 MAIN ST STE B",
            "city": "LAMONT",
            "state": "CA",
            "postal_code": "932411700",
            "telephone_number": "661-845-1788",
            "fax_number": "661-845-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA DEL PUEBLO MEDICAL GROUP CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-06",
        "last_updated": "2010-11-06",
        "status": "A",
        "authorized_official_last_name": "RATNAYAKE",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "661-377-3777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A056363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlos a. Alvarez, M.D., Inc
• Frank Cervantes, RN-BSN
• Clinca Sierra Vista
• Clinica del Pueblo
• Clinica del Pueblo Lamont
• Clinica Sierra Vista
• Clinica Sierra Vista (Lamont Community Health Center)
• Clinica Sierra Vista (Lamont Pharmacy)
• Clinica Sierra Vista (Lamont Adult Behavioral Health Services)
• Clinica Sierra Vista (Lamont Childrens Behavioral Health Services)

• Family Medicine Physician in Lamont, CA
• Providers in Lamont, 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 Nov 6, 2010; 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.