Pacific Neuro Diagnostic Medical Group, Inc.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

G15295 Issued in CA

Legal business name

PACIFIC NEURO DIAGNOSTIC MEDICAL GROUP, INC.

Practice address

165 W Hospitality LN
Suite 28
San Bernardino, CA 92408-3334

Phone

(909) 890-0046

NPI assigned

Jul 20, 2007

Organization subpart

No

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

Authorized official

Name

Sim C. Hoffman, MD

Title

President

Phone

(714) 995-5400

Specialties & licenses 8

Addresses

Tax ID family

Pacific Neuro Diagnostic Medical Group Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Pacific Neuro Diagnostic Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Panorama City, CA
  • NPI 1033318761
  NPD tax ID
• Pacific Neuro Diagnostic Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Palmdale, CA
  • NPI 1073712790
  NPD tax ID
• Pacific Neuro Diagnostic Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Oxnard, CA
  • NPI 1508056342
  NPD tax ID

Locations

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193443200000",
    "number": "1497955280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 LINCOLN AVE",
            "address_2": "SUITE 200",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906204162",
            "telephone_number": "714-995-5400",
            "fax_number": "714-995-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 W HOSPITALITY LN",
            "address_2": "SUITE 28",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083334",
            "telephone_number": "909-890-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC NEURO DIAGNOSTIC MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2007-10-27",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "SIM",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-995-5400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G15295",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Coast Podiatry PC
• Pacific Home Health
• Pacific Home Health Nursing, Inc.
• Pacific Hospice Inc.
• Pacific Hospice, Inc.
• Pacifica San Bernardino LLC
• Jesus Pacis, NP
• Tonda Cheri Padgett
• Claudia Solis Padilla, PA-C
• Crystal Padilla

• Orthopaedic Surgery Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2007; 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.