Organization Active NPI

Healthcare Medical Group of la Mesa

  • Specialist
  • La Mesa, CA
National Provider Identifier
1124165337
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A42653 Issued in CA
Legal business name
HEALTHCARE MEDICAL GROUP OF LA MESA
Practice address
7339 El Cajon Blvd
Suite I
La Mesa, CA 91941-3435
Phone
(619) 698-0606
Fax
(619) 698-0609
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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

Authorized official

Name
Dr. Venu Prabaker, M..D.
Title
Cep
Phone
(619) 698-0606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X A42653 CA Primary

Addresses

Primary practice location

7339 El Cajon Blvd
Suite I
La Mesa, CA 91941-3435

Mailing address

7339 El Cajon Blvd
Suite I
La Mesa, CA 91941-3435
Phone (619) 698-0606

National Provider Directory

National Provider Directory

Locations

7339 El Cajon Blvd
Ste 1
La Mesa, CA 91942
Phone (619) 668-6280

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377216000000",
    "number": "1124165337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7339 EL CAJON BLVD",
            "address_2": "SUITE I",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919413435",
            "telephone_number": "619-698-0606",
            "fax_number": "619-698-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7339 EL CAJON BLVD",
            "address_2": "SUITE I",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919413435",
            "telephone_number": "619-698-0606",
            "fax_number": "619-698-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHCARE MEDICAL GROUP OF LA MESA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2013-08-23",
        "status": "A",
        "authorized_official_last_name": "PRABAKER",
        "authorized_official_first_name": "VENU",
        "authorized_official_title_or_position": "CEP",
        "authorized_official_telephone_number": "619-698-0606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M..D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A42653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; 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.