Longevity Medical Institute LLC

Primary specialty

Sports Medicine (Preventive Medicine) PhysicianTaxonomy code 2083S0010X

Legal business name

LONGEVITY MEDICAL INSTITUTE LLC

Practice address

32 Villas del Mar
San Jose del Cabo, BAJA CALIFORNIA SUR 23406
MX

Phone

(702) 401-9300

NPI assigned

Oct 21, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Kirk Sanford, DCNPI 1194522128

Title

Ceo

Phone

(702) 401-8930

Specialties & licenses 1

Addresses

Practitioners 1

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

• Kirk Sanford, DC

  • Nutritionist
  • Houston, TX
  • NPI 1194522128
  NPD Authorized official

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1285455527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4521 SAN FELIPE ST UNIT 2902",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770273388",
            "telephone_number": "702-401-8930"
        },
        {
            "country_code": "MX",
            "country_name": "Mexico",
            "address_purpose": "LOCATION",
            "address_type": "FGN",
            "address_1": "32 VILLAS DEL MAR",
            "city": "SAN JOSE DEL CABO",
            "state": "BAJA CALIFORNIA SUR",
            "postal_code": "23406",
            "telephone_number": "702-401-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGEVITY MEDICAL INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-20",
        "status": "A",
        "authorized_official_last_name": "SANFORD",
        "authorized_official_first_name": "KIRK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-401-8930",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "2083S0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.