California Gen Medical Group, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CALIFORNIA GEN MEDICAL GROUP, INC

Practice address

5455 Wilshire Blvd Ste 1703
Los Angeles, CA 90036-4217

Phone

(213) 514-5674

Fax

(213) 514-5684

NPI assigned

May 10, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Hershel Tsikman, OWNER

Title

President

Phone

(213) 514-5674

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462838400000",
    "number": "1497101315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 WILSHIRE BLVD STE 1703",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364217",
            "telephone_number": "213-514-5674",
            "fax_number": "213-514-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 WILSHIRE BLVD STE 1703",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364217",
            "telephone_number": "213-514-5674",
            "fax_number": "213-514-5684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA GEN MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-10",
        "last_updated": "2016-05-10",
        "status": "A",
        "authorized_official_last_name": "TSIKMAN",
        "authorized_official_first_name": "HERSHEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-514-5674",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; 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.