Potential Medical Group

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

G072009 Issued in CA

Legal business name

POTENTIAL MEDICAL GROUP

Practice address

616 N Garfield Ave
203
Monterey Park, CA 91754-1141

Phone

(626) 280-9995

NPI assigned

May 25, 2007

Last updated

Aug 22, 2020By 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

Julie Sun, M.D

Title

Chief Executive Officer

Phone

(626) 280-9995

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437360047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 N GARFIELD AVE",
            "address_2": "203",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541141",
            "telephone_number": "626-280-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 N GARFIELD AVE",
            "address_2": "203",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541141",
            "telephone_number": "626-280-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTENTIAL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SUN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "626-280-9995",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "CA",
            "license": "G072009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Legal Medicine in Monterey Park, CA
• Providers in Monterey Park, CA by specialty
• Legal Medicine in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.