NPIMap

Organization Active NPI

Cole MD Medical Group, Inc.

  • Family Medicine Physician
  • Canoga Park, CA
National Provider Identifier
1386017366
Registry record updated Nov 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G67490 Issued in CA
Legal business name
COLE MD MEDICAL GROUP, INC.
Practice address
22203 Sherman Way
Canoga Park, CA 91303-1048
Phone
(818) 854-4400
NPI assigned
Nov 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2015

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

Authorized official

Name
Dyan Cole, M.D.
Title
President/Ceo
Phone
(818) 854-4400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X G67490 CA Primary

Addresses

Primary practice location

22203 Sherman Way
Canoga Park, CA 91303-1048

Mailing address

22203 Sherman Way
Canoga Park, CA 91303-1048
Phone (818) 854-4400

National Provider Directory

National Provider Directory

Locations

22203 Sherman Way
Canoga Park, CA 91303
Phone (818) 854-4400

NPI Registry JSON

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

{
    "created_epoch": "1447286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447286400000",
    "number": "1386017366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22203 SHERMAN WAY",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913031048",
            "telephone_number": "818-854-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22203 SHERMAN WAY",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913031048",
            "telephone_number": "818-854-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLE MD MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-12",
        "last_updated": "2015-11-12",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "DYAN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "818-854-4400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G67490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canoga Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.