Organization Active NPI

Joshua Jordan Medical Corporation

  • Internal Medicine Physician
  • South Gate, CA
National Provider Identifier
1295034395
Registry record updated Jun 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A10231 Issued in CA
Legal business name
JOSHUA JORDAN MEDICAL CORPORATION
Practice address
3275 Tweedy Blvd
South Gate, CA 90280-4348
Phone
(714) 262-5136
Fax
(310) 499-5261
NPI assigned
Mar 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2011

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

Authorized official

Name
Roya Masoud, DO
Title
President
Phone
(714) 262-5136

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 20A10231 CA Primary

Addresses

Primary practice location

3275 Tweedy Blvd
South Gate, CA 90280-4348

Mailing address

PO Box 27851
Anaheim, CA 92809-0128
Phone (714) 262-5136

National Provider Directory

National Provider Directory

Locations

3275 Tweedy Blvd
South Gate, CA 90280
Phone (323) 567-1212

NPI Registry JSON

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

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309132800000",
    "number": "1295034395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27851",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928090128",
            "telephone_number": "714-262-5136",
            "fax_number": "310-499-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3275 TWEEDY BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902804348",
            "telephone_number": "714-262-5136",
            "fax_number": "310-499-5261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSHUA JORDAN MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-15",
        "last_updated": "2011-06-27",
        "status": "A",
        "authorized_official_last_name": "MASOUD",
        "authorized_official_first_name": "ROYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-262-5136",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A10231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Gate, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.