Impala Medical Group

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

Legal business name

IMPALA MEDICAL GROUP

Practice address

2872 N Glassell St
Orange, CA 92865-1002

Phone

(714) 512-2850

NPI assigned

Jan 11, 2023

Last updated

Jan 11, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert T Nguyen, MD

Title

President/Cfo

Phone

(408) 728-3522

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1673395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673395200000",
    "number": "1346954518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2872 N GLASSELL ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928651002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2872 N GLASSELL ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928651002",
            "telephone_number": "714-512-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPALA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT/CFO",
        "authorized_official_telephone_number": "408-728-3522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hospice and Palliative Medicine (Internal Medicine) Physician in Orange, CA
• Providers in Orange, CA by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.