L & G Medical Group Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

G74551 Issued in CA

Legal business name

L & G MEDICAL GROUP INC

Practice address

1205 E North St
Manteca, CA 95336-4932

Phone

(209) 823-3111

NPI assigned

Dec 5, 2006

Organization subpart

No

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

Authorized official

Name

Saeed Gholami, MD

Title

Incorporator

Phone

(954) 255-5200

Specialties & licenses 1

Addresses

Other identifiers 1

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234396800000",
    "number": "1356409072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7156",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670156",
            "telephone_number": "209-467-6866",
            "fax_number": "209-467-6865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 E NORTH ST",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364932",
            "telephone_number": "209-823-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L & G MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2009-02-12",
        "status": "A",
        "authorized_official_last_name": "GHOLAMI",
        "authorized_official_first_name": "SAEED",
        "authorized_official_title_or_position": "INCORPORATOR",
        "authorized_official_telephone_number": "954-255-5200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G74551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G745512",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelley Marie Kohl, C.P.C.P. CERT.
• Esther Kolleh
• Jasleen Kumar
• George R Kunhardt, MD
• Nidhin Kurian, MS.,CCC-SLP
• Ruperto Labaria
• Richard Labelle, PSY. D.
• Amanda Marie Ladue, DPT
• Hong V Lam, LVN
• Kimberly Lam

• Anesthesiology Physician in Manteca, CA
• Providers in Manteca, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.