Peak Health Medical Group Inc

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

15137 Issued in CA

Legal business name

PEAK HEALTH MEDICAL GROUP INC

Practice address

1900 Pico Blvd
Santa Monica, CA 90405-1628

Phone

(310) 434-4262

NPI assigned

Oct 29, 2013

Organization subpart

No

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

Authorized official

Name

Kasiani GountoumasNPI 1194180646

Title

Nurse Practitioner

Phone

(310) 648-4802

Specialties & licenses 1

Addresses

Tax ID family

Peak Health Medical Group2 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.

• Peak Health Medical Group Inc

  • Non-Pharmacy Dispensing Site
  • Los Angeles, CA
  • NPI 1689019382
  NPD tax ID

Locations

Practitioners 1

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

• Kasiani Gountoumas

  • Family Nurse Practitioner
  • Santa Monica, CA
  • NPI 1194180646
  NPD (past) Authorized official

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383004800000",
    "number": "1386072429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2143 S SEPULVEDA BLVD STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 PICO BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051628",
            "telephone_number": "310-434-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK HEALTH MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2013-10-29",
        "status": "A",
        "authorized_official_last_name": "GOUNTOUMAS",
        "authorized_official_first_name": "KASIANI",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "310-648-4802"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "15137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michal T Payne
• Judith Paz, P.T.
• Marco Paz
• Pablo Pazmino, MD
• PC Care, LLC
• Peak Performance Consulting, Inc
• Pear Wilson Licensed Clinical Social Worker Inc
• Debra Susan Pear, D.C.
• Kaycey Pearce, PHARMD
• Michelle Pearce, L.M.F.T.

• Nurse Practitioner in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; 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.