NPIMap

Organization Active NPI

Park Terrace Medical Associates Inc

Doing business as Centre For Healthcare

  • Family Medicine Physician
  • Poway, CA
National Provider Identifier
1366685737
Registry record updated Apr 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PARK TERRACE MEDICAL ASSOCIATES INC
Doing business as
Centre For Healthcare
Practice address
15611 Pomerado Rd
Suite 400
Poway, CA 92064-2437
Phone
(858) 613-8900
Fax
(858) 618-1523
NPI assigned
Apr 14, 2009
Last updated
Apr 14, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
YESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 14, 2009

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

Authorized official

Name
Lawrence Andrew Koenig, M.D.NPI 1396715314
Title
Medical Director
Phone
(858) 613-8900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X
Family Nurse Practitioner 363LF0000X
Pediatric Nurse Practitioner 363LP0200X
Nutritionist 133N00000X
Allergy & Immunology Physician 207K00000X
Dermatology Physician 207N00000X
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
Ophthalmology Physician 207W00000X
Orthopaedic Surgery Physician 207X00000X
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X
Pediatrics Physician 208000000X
Surgery Physician 208600000X
Sleep Medicine (Otolaryngology) Physician 207YS0012X

Addresses

Primary practice location

15611 Pomerado Rd
Suite 400
Poway, CA 92064-2437

Mailing address

15611 Pomerado Rd
Suite 400
Poway, CA 92064-2437
Phone (858) 613-8900

Other names 1

  • Centre For Healthcare Doing business as

National Provider Directory

National Provider Directory
Part of
Park Terrace Medical Associates Inc

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239667200000",
    "number": "1366685737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15611 POMERADO RD",
            "address_2": "SUITE 400",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642437",
            "telephone_number": "858-613-8900",
            "fax_number": "858-618-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15611 POMERADO RD",
            "address_2": "SUITE 400",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642437",
            "telephone_number": "858-613-8900",
            "fax_number": "858-618-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK TERRACE MEDICAL ASSOCIATES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YES",
        "enumeration_date": "2009-04-14",
        "last_updated": "2009-04-14",
        "status": "A",
        "authorized_official_last_name": "KOENIG",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "858-613-8900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centre For Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poway, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.