NPIMap

Organization Active NPI

California Mobile Doctors Group Inc

  • Family Medicine Physician
  • West Covina, CA
National Provider Identifier
1427672385
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CALIFORNIA MOBILE DOCTORS GROUP INC
Practice address
1317 W West Covina Pkwy Ste B
West Covina, CA 91790-2800
Phone
(310) 733-8706
NPI assigned
Jun 5, 2020
Last updated
Jun 25, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Authorized official

Name
Ms. Raizsa B Acuna
Title
President/Ceo
Phone
(310) 733-8706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1317 W West Covina Pkwy Ste B
West Covina, CA 91790-2800

Mailing address

1317 W West Covina Pkwy Ste B
West Covina, CA 91790-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200730000472 CA Part B Supplier - Clinic/Group Practice 3779908306 Receives reassigned benefits from 14 practitioners
Practice locations: Northridge, CA

National Provider Directory

National Provider Directory

Locations

8619 Reseda Blvd
Ste 201
Northridge, CA 91324
Phone (747) 217-8863

1317 W West Covina Pkwy
Ste B
West Covina, CA 91790
Phone (310) 733-8706

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593043200000",
    "number": "1427672385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 W WEST COVINA PKWY STE B",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 W WEST COVINA PKWY STE B",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902800",
            "telephone_number": "310-733-8706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA MOBILE DOCTORS GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-05",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A",
        "authorized_official_last_name": "ACUNA",
        "authorized_official_first_name": "RAIZSA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "310-733-8706",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; 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.