Clinica del Pueblo Carcamo a Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CLINICA DEL PUEBLO CARCAMO A MEDICAL CORPORATION

Doing business as

Clinica del Pueblo Carcamo

Practice address

14650 Pacific Ave
Baldwin Park, CA 91706-5333

Phone

(626) 337-1360

Fax

(626) 962-1375

NPI assigned

Sep 2, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Octavio Ruiz-Villalpando, MD

Title

President/Owner

Phone

(909) 815-1991

Specialties & licenses 1

Addresses

Other names 1

• Clinica del Pueblo Carcamo Doing business as

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599004800000",
    "number": "1477167062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14083 HASTINGS RANCH LN",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917392112",
            "telephone_number": "951-285-4393",
            "fax_number": "760-948-6244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14650 PACIFIC AVE",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917065333",
            "telephone_number": "626-337-1360",
            "fax_number": "626-962-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA DEL PUEBLO CARCAMO A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-02",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-01",
        "status": "A",
        "authorized_official_last_name": "RUIZ-VILLALPANDO",
        "authorized_official_first_name": "OCTAVIO",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "909-815-1991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinica del Pueblo Carcamo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Jeffrey Michael Cohen, MD
• Ross Adam Cohen, DO

• Family Medicine Physician in Baldwin Park, CA
• Providers in Baldwin Park, CA by specialty
• Family Medicine Physician in California

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