NPIMap

Organization Active NPI

Golden Eagle Medical Network

  • Obstetrics & Gynecology Physician
  • La Puente, CA
National Provider Identifier
1255697736
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A 39722 Issued in CA
Legal business name
GOLDEN EAGLE MEDICAL NETWORK
Practice address
1025 N Willow Ave
La Puente, CA 91746-1617
Phone
(626) 960-6666
Fax
(626) 960-5666
NPI assigned
Apr 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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

Authorized official

Name
Jacinto Lam, MD
Title
President
Phone
(626) 960-6666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X A 39722 CA Primary

Addresses

Primary practice location

1025 N Willow Ave
La Puente, CA 91746-1617

Mailing address

1025 N Willow Ave
La Puente, CA 91746-1617
Phone (626) 960-6666

Other names 1

  • CLINICA MEDICA SAN PEDRO NETWORK Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clinica Medica San Pedro Network4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333929600000",
    "number": "1255697736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 N WILLOW AVE",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917461617",
            "telephone_number": "626-960-6666",
            "fax_number": "626-960-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 N WILLOW AVE",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917461617",
            "telephone_number": "626-960-6666",
            "fax_number": "626-960-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN EAGLE MEDICAL NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-09",
        "last_updated": "2012-04-09",
        "status": "A",
        "authorized_official_last_name": "LAM",
        "authorized_official_first_name": "JACINTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-960-6666",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A 39722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINICA MEDICA SAN PEDRO NETWORK",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Puente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; 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.