First Americans Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FIRST AMERICANS MEDICAL GROUP, INC.

Practice address

12359 Malki Rd
Banning, CA 92220-6974

Phone

(951) 922-2058

Fax

(888) 551-2116

NPI assigned

Oct 16, 2019

Last updated

Oct 16, 2019By 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

James Novak, MD

Title

Medical Director

Phone

(858) 270-7633

Specialties & licenses 1

Addresses

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.

• Shu Dong, N.P.

  • Nurse Practitioner
  • Banning, CA
  • NPI 1376842005
  NPD

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1376185843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 LAMONT ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921094560",
            "telephone_number": "858-270-7633",
            "fax_number": "858-270-7692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12359 MALKI RD",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922206974",
            "telephone_number": "951-922-2058",
            "fax_number": "888-551-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST AMERICANS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A",
        "authorized_official_last_name": "NOVAK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "858-270-7633",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Banning, CA
• Providers in Banning, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.