Medaid Center

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

C50464 Issued in CA

Legal business name

MEDAID CENTER

Practice address

5580 La Jolla Blvd
Suite 611
La Jolla, CA 92037-7651

Phone

(858) 405-9653

NPI assigned

May 22, 2009

Organization subpart

No

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

Authorized official

Name

Mark C HendersonNPI 1184895856

Title

Ceo

Phone

(858) 405-9653

Specialties & licenses 1

Addresses

Practitioners 1

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

• Mark C Henderson, M.D.

  • Internal Medicine Physician
  • Sacramento, CA
  • NPI 1184895856
  NPD (past) Authorized official

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

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250294400000",
    "number": "1508091307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5580 LA JOLLA BLVD",
            "address_2": "SUITE 611",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920377651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5580 LA JOLLA BLVD",
            "address_2": "SUITE 611",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920377651",
            "telephone_number": "858-405-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDAID CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-22",
        "last_updated": "2009-08-15",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "858-405-9653"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C50464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MD2 la Jolla
• Audra R Meadows, MD, MPH
• Coleman D Meadows, D.D.S.
• Margaret Frances Meagher
• Charles Mears
• Anthony J Medak, MD
• Fernando Mediano
• Chad David Mediate, D.P.T.
• Michelle Lynn Medicke, DPT
• Medihelp24

• Internal Medicine Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2009; 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.