Drlavida Medical Group, Inc.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

DRLAVIDA MEDICAL GROUP, INC.

Practice address

101 E Beverly Blvd Ste 201
Montebello, CA 90640-4315

Phone

(213) 321-4125

Fax

(805) 253-7186

NPI assigned

Mar 9, 2020

Last updated

Jan 12, 2021By 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

Steven Anh Phung

Title

President

Phone

(213) 321-4125

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1583712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610409600000",
    "number": "1447885538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E BEVERLY BLVD STE 201",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404315",
            "telephone_number": "213-321-4125",
            "fax_number": "805-253-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E BEVERLY BLVD STE 201",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404315",
            "telephone_number": "213-321-4125",
            "fax_number": "805-253-7186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRLAVIDA MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-09",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A",
        "authorized_official_last_name": "PHUNG",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "ANH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-321-4125"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "SERVER",
            "affiliation": "N",
            "endpointDescription": "BUENA PARK",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6850 Lincoln Ave Ste 103E",
            "city": "Buena Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "906204179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Health Service Clinic/Center in Montebello, CA
• Providers in Montebello, CA by specialty
• Health Service Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.