Direct Access Medical Group

Key facts

NPI

1376765883

Entity type

Organization (NPI type 2)

Primary specialty

Sleep Medicine (Internal Medicine) Physician 207RS0012X

Legal business name

DIRECT ACCESS MEDICAL GROUP

Practice address

16661 Ventura Blvd.
Suite 604
Encino, AL 91436

Phone

(818) 788-8213

Fax

(818) 788-8343

NPI assigned

May 3, 2007

Organization subpart

No

Authorized official

Name

Sean Leoni, M.D.

Title

President

Phone

(818) 788-8213

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376765883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16661 VENTURA BLVD.",
            "address_2": "SUITE 604",
            "city": "ENCINO",
            "state": "AL",
            "postal_code": "91436",
            "telephone_number": "818-788-8213",
            "fax_number": "818-788-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16661 VENTURA BLVD.",
            "address_2": "SUITE 604",
            "city": "ENCINO",
            "state": "AL",
            "postal_code": "91436",
            "telephone_number": "818-788-8213",
            "fax_number": "818-788-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECT ACCESS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEONI",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-788-8213",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}