Kondovski Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A6077 Issued in CA

Legal business name

KONDOVSKI MEDICAL GROUP

Practice address

79440 Corporate Center Dr. Ste 110
La Quinta, CA 92253-7241

Phone

(760) 565-6969

Fax

(760) 565-6966

NPI assigned

Sep 30, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Sacho Rade Kondovski, D.O.

Title

Owner

Phone

(760) 565-6969

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Kondovski Medical Group Doing business as

Locations

Practitioners 1

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

• Margaret Carrizosa, NP

  • Family Nurse Practitioner
  • Palm Desert, CA
  • NPI 1003068289
  NPD

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1184933699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79440 CORPORATE CENTER DR. STE 110",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922537241",
            "telephone_number": "760-565-6969",
            "fax_number": "760-565-6966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79440 CORPORATE CENTER DR. STE 110",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922537241",
            "telephone_number": "760-565-6969",
            "fax_number": "760-565-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KONDOVSKI MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-30",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "KONDOVSKI",
        "authorized_official_first_name": "SACHO",
        "authorized_official_middle_name": "RADE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-565-6969",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID - TYPE UNSPECIFIED",
            "identifier": "020A60770",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "20A6077",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kondovski Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Veronica Klein, NP
• Knight Chiropractic, Inc.
• Charles Duane Knight, D.C.
• George Henry Koenig, M.D.
• Stephanie D Kolsrud, RDN
• Alexander Korn, M.D.
• Koushan Siami M D a Professional Corporation
• Thomas James Krisko, PTA
• Kristen Bohnet, DC, Lac, Acupuncture Corporation
• Debra J Kuracina, M.D.

• Family Medicine Physician in La Quinta, CA
• Providers in La Quinta, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.