Anatomical Impairment Medical Group, Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

FNP41580 Issued in CA

Legal business name

ANATOMICAL IMPAIRMENT MEDICAL GROUP, INC

Practice address

2500 E. Ball Road Ste 200
Anaheim, CA 92806

Phone

(714) 284-0111

Fax

(714) 284-0433

NPI assigned

Mar 12, 2013

Last updated

Mar 12, 2013By 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

Ms. Ghazala Ahmed

Title

Secretary

Phone

(714) 284-0111

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363046400000",
    "number": "1407197718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E. BALL ROAD STE 200",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92806",
            "telephone_number": "714-284-0111",
            "fax_number": "714-284-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E. BALL ROAD STE 200",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92806",
            "telephone_number": "714-284-0111",
            "fax_number": "714-284-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANATOMICAL IMPAIRMENT MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-12",
        "last_updated": "2013-03-12",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "GHAZALA",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "714-284-0111",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "FNP41580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Specialist in California

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