Maxlife Medical Group Inc

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

MAXLIFE MEDICAL GROUP INC

Practice address

11161 Washington Blvd
Whittier, CA 90606-3007

Phone

(562) 800-0603

Fax

(562) 800-0605

NPI assigned

May 30, 2023

Organization subpart

No

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

Authorized official

Name

Sam Jeffery

Title

Manager

Phone

(562) 800-0603

Specialties & licenses 2

Addresses

Other names 1

• Maxlife Urgent Care Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Valentine U Otuechere, MD., MPH.

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1508896275
  Medicare reassignment NPD
• Rafael Arturo Penunuri, M.D.

  • Internal Medicine Physician
  • Newport Beach, CA
  • NPI 1831270362
  Medicare reassignment NPD

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

{
    "created_epoch": "1685404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1487347183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11161 WASHINGTON BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906063007",
            "telephone_number": "562-800-0603",
            "fax_number": "562-800-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11161 WASHINGTON BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906063007",
            "telephone_number": "562-800-0603",
            "fax_number": "562-800-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXLIFE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "JEFFERY",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "562-800-0603"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maxlife Urgent Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matrix Rehabilitation, Inc.
• Brianna Michol Matthews
• Andrea Tatyana Maushardt
• Sarah Elaine Diruscio Maust, C.N.M., R.N.
• Will Max, M.A.
• Rudolf Ernst Mayer, DDS
• Mazloomi Whittier DDS Inc
• Meghann McCall-O'Dell, DC, MAT, ATC
• Karen Elizabeth McCandliss
• John D. McCarthy

• Urgent Care Clinic/Center in Whittier, CA
• Providers in Whittier, CA by specialty
• Urgent Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.