VN Healthy Living Medical Group Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

VN HEALTHY LIVING MEDICAL GROUP INC

Practice address

707 Palm Ave
Imperial Beach, CA 91932-1229

Phone

(619) 429-7700

NPI assigned

Nov 21, 2022

Organization subpart

No

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

Authorized official

Name

Vijay Kuppurajan, MDNPI 1326669060

Title

Physician Owner

Phone

(619) 955-0807

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

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

• Vijay Krishna Kuppurajan

  • Internal Medicine Physician
  • Imperial Beach, CA
  • NPI 1326669060
  Medicare reassignment NPD Authorized official
• Nisha Kuruvadi

  • Internal Medicine Physician
  • Chula Vista, CA
  • NPI 1104322239
  Medicare reassignment NPD
• Vernon Greg Phillips, MD

  • Family Medicine Physician
  • Imperial Beach, CA
  • NPI 1427062918
  NPD (past)

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1154030955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 PALM AVE",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919321229",
            "telephone_number": "619-429-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 PALM AVE",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919321229",
            "telephone_number": "619-429-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VN HEALTHY LIVING MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-21",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "KUPPURAJAN",
        "authorized_official_first_name": "VIJAY",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "619-955-0807",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lora Jane Urig, D.C.
• Ida Chen Van Houten, RN
• Marianela Vasquez-Sosa, PHARMACIST
• Taylor Verissimo, PT
• Giovanni Xavier Villanueva, DPT
• Adia Adriana Warren
• Janelle Way
• Audrey Lee Weiss, OD
• Deidre Deacon White, PT, DPT
• Lance Anthony White

• Internal Medicine Physician in Imperial Beach, CA
• Providers in Imperial Beach, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.