New Age Med Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G80567 Issued in CA

Legal business name

NEW AGE MED GROUP

Practice address

1827 Ximeno Ave
Suite 6
Long Beach, CA 90815-2850

Phone

(562) 606-9474

NPI assigned

Mar 14, 2009

Last updated

Jun 2, 2009By 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

Karl J Gebhard

Title

Ceo

Phone

(562) 606-9474

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1236988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1427299858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1827 XIMENO AVE",
            "address_2": "SUITE 6",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908152850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1827 XIMENO AVE",
            "address_2": "SUITE 6",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908152850",
            "telephone_number": "562-606-9474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW AGE MED GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-14",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "GEBHARD",
        "authorized_official_first_name": "KARL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-606-9474"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G80567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; 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.