R G W Multi Specialty Medical Group Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

A23457 Issued in CA

Legal business name

R G W MULTI SPECIALTY MEDICAL GROUP INC

Practice address

1915 W Glenoaks Blvd
Suite 101
Glendale, CA 91201-1541

Phone

(818) 955-9902

Fax

(818) 955-9987

NPI assigned

Nov 16, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Randall G Weissbuch, M.D.

Title

Owner

Phone

(818) 955-9902

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1104127505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 W GLENOAKS BLVD",
            "address_2": "SUITE 101",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912011541",
            "telephone_number": "818-955-9902",
            "fax_number": "818-955-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 W GLENOAKS BLVD",
            "address_2": "SUITE 101",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912011541",
            "telephone_number": "818-955-9902",
            "fax_number": "818-955-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R G W MULTI SPECIALTY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "WEISSBUCH",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-955-9902",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": "A23457",
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shayan Rad, PSY.D.

• Multi-Specialty Clinic/Center in Glendale, CA
• Providers in Glendale, 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 Nov 16, 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.