Organization Active NPI

Richard B. Jurmain Medical Corporation

  • Cardiovascular Disease Physician
  • Culver City, CA
National Provider Identifier
1366474868
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A22905 Issued in CA
Legal business name
RICHARD B. JURMAIN MEDICAL CORPORATION
Practice address
9808 Venice Blvd
Suite 503
Culver City, CA 90232-2732
Phone
(310) 815-1650
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Authorized official

Name
Richard B Jurmain, M.D.NPI 1174555775
Title
President
Phone
(310) 815-1650

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X A22905 CA Primary

Addresses

Primary practice location

9808 Venice Blvd
Suite 503
Culver City, CA 90232-2732

Mailing address

9808 Venice Blvd
Suite 503
Culver City, CA 90232-2732
Phone (310) 815-1650

Other identifiers 1

IdentifierTypeStateIssuer
WA22905BOtherCARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050630001045 CA Part B Supplier - Clinic/Group Practice 2668418500 Receives reassigned benefits from 1 practitioner
Practice locations: Culver City, CA

National Provider Directory

National Provider Directory
Tax ID family
Richard B Jurmain MD Medical Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3831 Hughes Ave
Ste 604
Culver City, CA 90232
Phone (310) 730-8606

9808 Venice Blvd
Ste 503
Culver City, CA 90232
Phone (310) 204-5510

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1366474868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9808 VENICE BLVD",
            "address_2": "SUITE 503",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322732",
            "telephone_number": "310-815-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9808 VENICE BLVD",
            "address_2": "SUITE 503",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322732",
            "telephone_number": "310-815-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD B. JURMAIN MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "JURMAIN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-815-1650",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A22905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "WA22905B",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.