International Medical Group Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

532014 Issued in CA

Legal business name

INTERNATIONAL MEDICAL GROUP INC

Practice address

14431 Ventura Blvd # 507
Sherman Oaks, CA 91423-2606

Phone

(323) 893-6632

Fax

(323) 417-4865

NPI assigned

May 19, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Anthony Vera, MD

Title

Ceo

Phone

(323) 893-6632

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• International Medical Group Inc Home Health & Hospice Doing business as

Practitioners 1

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

• De Wayne D Dela Guerra, LVN

  • Licensed Vocational Nurse
  • Los Angeles, CA
  • NPI 1457695736
  NPD

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

{
    "created_epoch": "1495152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1215464334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14431 VENTURA BLVD",
            "address_2": "#507",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914230152",
            "telephone_number": "323-893-6632",
            "fax_number": "323-417-4865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14431 VENTURA BLVD # 507",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914232606",
            "telephone_number": "323-893-6632",
            "fax_number": "323-417-4865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "514 S Mariposa Ave Apt 103",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900202805",
            "country_code": "US",
            "telephone_number": "323-419-2440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTERNATIONAL MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-19",
        "last_updated": "2022-07-21",
        "certification_date": "2020-09-21",
        "status": "A",
        "authorized_official_last_name": "VERA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-893-6632",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "532014",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215464334",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "International Medical Group Inc Home Health & Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.