Active NPI
Family Medicine Associates of Northridge a Medical Group Inc
- Family Medicine Physician
- Northridge, CA
National Provider Identifier
1104984327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- FAMILY MEDICINE ASSOCIATES OF NORTHRIDGE A MEDICAL GROUP INC
- Practice address
- 18350 Roscoe Blvd
Suite 600
Northridge, CA 91325 - Phone
- (818) 727-1515
- Fax
- (818) 727-7997
- NPI assigned
- Dec 4, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Elizabeth Eddy-Bertrand, MD
- Title
- President
- Phone
- (818) 727-1515
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
18350 Roscoe Blvd
Suite 600
Northridge, CA 91325
Mailing address
18350 Roscoe Blvd
Suite 600
Northridge, CA 91325
Phone (818) 727-1515
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0061720 | Medicaid | CA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0916950 | Family Medicine Associates-Northridge | Provider-performed microscopy | Apr 30, 2027 |
National Provider Directory
National Provider DirectoryNetworks
- BSC 65 PLUS INDIVIDUAL MAPD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1748390400000",
"number": "1104984327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18350 ROSCOE BLVD",
"address_2": "SUITE 600",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "91325",
"telephone_number": "818-727-1515",
"fax_number": "818-727-7997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18350 ROSCOE BLVD",
"address_2": "SUITE 600",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "91325",
"telephone_number": "818-727-1515",
"fax_number": "818-727-7997"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY MEDICINE ASSOCIATES OF NORTHRIDGE A MEDICAL GROUP INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-04",
"last_updated": "2025-05-28",
"certification_date": "2025-05-28",
"status": "A",
"authorized_official_last_name": "EDDY-BERTRAND",
"authorized_official_first_name": "ELIZABETH",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "818-727-1515",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0061720",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Northridge, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.