Cordova Medical & Diagnostic Group Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A51101 Issued in CA

Legal business name

CORDOVA MEDICAL & DIAGNOSTIC GROUP INC

Practice address

26732 Crown Valley Pkwy
Ste 421
Mission Viejo, CA 92691-6306

Phone

(949) 347-8721

Fax

(949) 347-8709

NPI assigned

Sep 15, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Warner Glassford

Title

Cfo

Phone

(310) 775-7795

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317945600000",
    "number": "1285916221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26732 CROWN VALLEY PKWY",
            "address_2": "STE 421",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916306",
            "telephone_number": "949-347-8721",
            "fax_number": "949-347-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26732 CROWN VALLEY PKWY",
            "address_2": "STE 421",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916306",
            "telephone_number": "949-347-8721",
            "fax_number": "949-347-8709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORDOVA MEDICAL & DIAGNOSTIC GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-15",
        "last_updated": "2011-10-07",
        "status": "A",
        "authorized_official_last_name": "GLASSFORD",
        "authorized_official_first_name": "WARNER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "310-775-7795",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A51101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Coons, PSYCHOLOGIST
• Casey Cooper, PHD
• Coordinated Lab Services, LLC
• Chelsea Danielle Cord, FNP-BC
• Elizabeth Thelma Cordes, PHD, LMFT, JD
• Corey Corpodian DDS, Inc.
• Blythe Noel Corgiat
• Samuel Roy Cornell, DC, ATC
• Casey Cortes, PMHNP-BC
• Ashley Noel Cortez, LCSW

• General Practice Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.