NPIMap

Organization Active NPI

Jamacha Medical Group Inc

  • Family Medicine Physician
  • El Cajon, CA
National Provider Identifier
1205244738
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A52314 Issued in CA
Legal business name
JAMACHA MEDICAL GROUP INC
Practice address
1679 E Main St
Suite 206
El Cajon, CA 92021-5212
Phone
(619) 579-6300
Fax
(619) 579-0040
NPI assigned
Jul 29, 2014
Last updated
Jul 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Authorized official

Name
Dr. Muhammad Anwarul Azam, M.D.NPI 1740244367
Title
Owner
Phone
(619) 579-6300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A52314 CA Primary

Addresses

Primary practice location

1679 E Main St
Suite 206
El Cajon, CA 92021-5212

Mailing address

1679 E Main St
Suite 206
El Cajon, CA 92021-5212
Phone (619) 579-6300

Other identifiers 1

IdentifierTypeStateIssuer
A0052314MedicaidCA

National Provider Directory

National Provider Directory

Locations

1679 E Main St
Ste 206
El Cajon, CA 92021
Phone (619) 579-6300

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406592000000",
    "number": "1205244738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1679 E MAIN ST",
            "address_2": "SUITE 206",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920215212",
            "telephone_number": "619-579-6300",
            "fax_number": "619-579-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1679 E MAIN ST",
            "address_2": "SUITE 206",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920215212",
            "telephone_number": "619-579-6300",
            "fax_number": "619-579-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMACHA MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-29",
        "last_updated": "2014-07-29",
        "status": "A",
        "authorized_official_last_name": "AZAM",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_middle_name": "ANWARUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-579-6300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A52314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A0052314",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.