Family Medical Group, a Professional Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G43405 Issued in CA

Legal business name

FAMILY MEDICAL GROUP, A PROFESSIONAL CORPORATION

Practice address

1800 Sullivan Ave RM 209
Daly City, CA 94015

Phone

(650) 994-2300

Fax

(650) 992-0122

NPI assigned

Dec 6, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Ann Omachi, MD

Title

President

Phone

(650) 994-2300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535587200000",
    "number": "1184783136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 SULLIVAN AVE RM 209",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152222",
            "telephone_number": "650-994-2300",
            "fax_number": "650-992-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SULLIVAN AVE RM 209",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "94015",
            "telephone_number": "650-994-2300",
            "fax_number": "650-992-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL GROUP, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2018-08-30",
        "status": "A",
        "authorized_official_last_name": "OMACHI",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-994-2300",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G43405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ837527",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chinwe Ezeonu
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• Ping Christina Fan, REGISTERED NURSE
• Viola Fan, DPT, PT, MS
• Lauren Michelle Fanjoy, AMFT
• Farallon Eye Physicians Corp
• Brianna Therese Farias

• Internal Medicine Physician in Daly City, CA
• Providers in Daly City, 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 Aug 30, 2018; 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.