Antioch Medical Park Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A19234 Issued in CA

Legal business name

ANTIOCH MEDICAL PARK MEDICAL GROUP

Practice address

3737 Lone Tree Way
Antioch, CA 94509-6065

Phone

(925) 754-9223

Fax

(925) 754-3945

NPI assigned

Sep 6, 2006

Organization subpart

No

Name

Dr. J Gene Zimmerman, MD

Title

Senior MD

Phone

(925) 754-9223

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Antioch Medical Park Medical Lab

  • Clinical Medical Laboratory
  • Antioch, CA
  • NPI 1518142090
  NPPES parent name

Locations

• ANTIOCH MEDICAL PARK Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 23, 2008.

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201046400000",
    "number": "1154424299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 LONE TREE WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096065",
            "telephone_number": "925-754-9223",
            "fax_number": "925-754-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 LONE TREE WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096065",
            "telephone_number": "925-754-9223",
            "fax_number": "925-754-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTIOCH MEDICAL PARK MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2008-01-23",
        "status": "A",
        "authorized_official_last_name": "ZIMMERMAN",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "SENIOR MD",
        "authorized_official_telephone_number": "925-754-9223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A19234",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G44114",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ76320Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ANTIOCH MEDICAL PARK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Antioch Icf Inc
• Antioch Icf Inc
• Antioch Icf Inc
• Antioch Icf, Inc
• Antioch Medical and Hospital Supply, Inc.
• Antioch Medical Park Medical Lab
• Antioch Optometry, PC
• Antioch Physical Therapy and Sports Injury Center Inc.
• Antioch Rehab
• Antioch Unified School District

• All providers in Antioch, CA
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; 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.