Prima Vida Medical Clinic, Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A66742 Issued in CA

Legal business name

PRIMA VIDA MEDICAL CLINIC, INC.

Practice address

8706 Imperial Hwy
Downey, CA 90242-3906

Phone

(562) 923-8300

NPI assigned

Jun 28, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Eleanor Verzosa Azurin, M.D.

Title

President

Phone

(562) 923-8300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

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

• Cherry Mae Endo, F.N.P

  • Family Nurse Practitioner
  • Downey, CA
  • NPI 1831634559
  NPD (past)

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357084800000",
    "number": "1407143464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8706 IMPERIAL HWY",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902423906",
            "telephone_number": "562-923-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8706 IMPERIAL HWY",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902423906",
            "telephone_number": "562-923-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMA VIDA MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-28",
        "last_updated": "2013-01-02",
        "status": "A",
        "authorized_official_last_name": "AZURIN",
        "authorized_official_first_name": "ELEANOR",
        "authorized_official_middle_name": "VERZOSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-923-8300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A66742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407143464",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Downey, CA
• Providers in Downey, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.