Deguzman Medical Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

License

A046594 Issued in CA

Legal business name

DEGUZMAN MEDICAL CORPORATION

Practice address

1525 Superior Ave
Suite 200
Newport Beach, CA 92663
UM

Phone

(949) 650-0506

NPI assigned

Jul 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Lino J Deguzman, M.D.NPI 1346324720

Title

Owner

Phone

(949) 650-0506

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Lino J Deguzman, M.D.

  • Gastroenterology Physician
  • Irvine, CA
  • NPI 1346324720
  Medicare reassignment NPD Authorized official
• Anne Marie Burkel, PA-C

  • Medical Physician Assistant
  • Newport Beach, CA
  • NPI 1942634753
  Medicare reassignment

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398988800000",
    "number": "1245438787",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "1525 SUPERIOR AVE",
            "address_2": "SUITE 200",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92663",
            "telephone_number": "949-650-0506"
        },
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "LOCATION",
            "address_type": "FGN",
            "address_1": "1525 SUPERIOR AVE",
            "address_2": "SUITE 200",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92663",
            "telephone_number": "949-650-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEGUZMAN MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2014-05-02",
        "status": "A",
        "authorized_official_last_name": "DEGUZMAN",
        "authorized_official_first_name": "LINO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-650-0506",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A046594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0087281",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.