Executive Medicine, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A97256 Issued in CA

Legal business name

EXECUTIVE MEDICINE, INC.

Practice address

1227 Buena Vista St
Suite #F
Duarte, CA 91010-2486

Phone

(877) 254-4496

Fax

(877) 254-4496

NPI assigned

May 6, 2013

Organization subpart

No

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

Authorized official

Name

Ulin Sargeant, MDNPI 1992878151

Title

President

Phone

(877) 254-4496

Specialties & licenses 1

Addresses

Other names 1

• Monrovia Internal Medicine and Primary Care Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Executive Medicine, Inc.

  • Urgent Care Clinic/Center
  • Duarte, CA
  • NPI 1033965413

  O20150610000175

  Same enrollment

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Executive Medicine, Inc.

  • Urgent Care Clinic/Center
  • Duarte, CA
  • NPI 1033965413
  NPPES parent name

Practitioners 4

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

• Ulin Sargeant, M.D., MPH

  • Internal Medicine Physician
  • Duarte, CA
  • NPI 1992878151
  Medicare reassignment Authorized official
• Xuan Hao Thi Doan, PA

  • Medical Physician Assistant
  • Torrance, CA
  • NPI 1831802578
  Medicare reassignment
• Summer Denaye Gonzales, PA

  • Physician Assistant
  • Oakland, CA
  • NPI 1245979756
  Medicare reassignment
• James Matthew Wantuck, M.D.

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1821301110
  NPD (past)

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1407291347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2063",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910176063",
            "telephone_number": "877-254-4496",
            "fax_number": "877-254-4496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 BUENA VISTA ST",
            "address_2": "SUITE #F",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910102486",
            "telephone_number": "877-254-4496",
            "fax_number": "877-254-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-06",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "SARGEANT",
        "authorized_official_first_name": "ULIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "877-254-4496",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A97256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monrovia Internal Medicine and Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holly Ann-Marie Escalera, AMFT
• Mark Esensten, MD
• Carin Espenschied, MS, CGC
• Evelinda Gene N Evangelista
• Executive Medicine, Inc.
• Maeva Martina Fabila
• Mildred Gabot Fabros, PA-C
• Bridget N. Fahy-Chandon, M.D.
• Marwan G Fakih, MD
• Andres Falabella, MD

• Internal Medicine Physician in Duarte, CA
• Providers in Duarte, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.