TDJ MD Group Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A34329 Issued in CA

Legal business name

TDJ MD GROUP INC

Practice address

12826 Victory Blvd Ste E
N Hollywood, CA 91606-3065

Phone

(818) 583-0050

NPI assigned

Oct 3, 2017

Organization subpart

No

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

Authorized official

Name

Thomas Dosumu-Johnson, M.D.

Title

Ceo

Phone

(562) 733-9789

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506988800000",
    "number": "1245740331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12826 VICTORY BLVD STE E",
            "city": "N HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063065",
            "telephone_number": "818-583-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12826 VICTORY BLVD STE E",
            "city": "N HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063065",
            "telephone_number": "818-583-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TDJ MD GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-03",
        "last_updated": "2017-10-03",
        "status": "A",
        "authorized_official_last_name": "DOSUMU-JOHNSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-733-9789",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A34329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in N Hollywood, CA
• Providers in N Hollywood, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2017; 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.