Sana Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G69567 Issued in CA

Legal business name

SANA MEDICAL GROUP, INC.

Practice address

12099 W Washington Blvd
Ste 400
Los Angeles, CA 90066-5882

Phone

(310) 398-3803

NPI assigned

Jan 8, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jose L Villagomez, M.D.NPI 1699717462

Title

President

Phone

(310) 398-3803

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Sana Medical Group Other name

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 2

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

• Jose L Villagomez, MD

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1699717462
  Medicare reassignment NPD Authorized official
• Katharine Anne Piuze, NP

  • Family Nurse Practitioner
  • Los Angeles, CA
  • NPI 1376833079
  NPD (past)

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291766400000",
    "number": "1194900175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12099 W WASHINGTON BLVD",
            "address_2": "STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900665882",
            "telephone_number": "310-398-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12099 W WASHINGTON BLVD",
            "address_2": "STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900665882",
            "telephone_number": "310-398-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANA MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2010-12-08",
        "status": "A",
        "authorized_official_last_name": "VILLAGOMEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-398-3803",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G69567",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A61283",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "GR0086970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sana Medical Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• San Vicente Women'S Total Health Center Inc
• San Vincente Women'S Total Health Center Inc
• Samoan San
• Sandy San
• Tin Moe San
• Aron Jason Sanabria, M.A
• Juliana Elyse Sanabria
• Marilyn Sanabria, B.A.
• Tifanni Crystal Sanabria
• Virginia Elizabeth Sanabria

• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, 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 Dec 8, 2010; 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.