NPIMap

Organization Active NPI

Spinal Rehabilitation Medical Group, Inc.

  • Non-Pharmacy Dispensing Site
  • Santa Monica, CA
National Provider Identifier
1508157801
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
SPINAL REHABILITATION MEDICAL GROUP, INC.
Practice address
2317 Broadway
Santa Monica, CA 90404-2915
Phone
(310) 829-2225
NPI assigned
Apr 21, 2011
Last updated
Apr 21, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
SPINAL REHABILITATION MEDICAL GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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

Authorized official

Name
Jorge Moran, M.D.
Title
Medical Director
Phone
(310) 829-2225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

2317 Broadway
Santa Monica, CA 90404-2915

Mailing address

2980 N Beverly Glen Cir
Suite 301
Los Angeles, CA 90077-1726
Phone (310) 474-9809

National Provider Directory

National Provider Directory
Part of
Spinal Rehab Medical Group

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1303344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303344000000",
    "number": "1508157801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR",
            "address_2": "SUITE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771726",
            "telephone_number": "310-474-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 BROADWAY",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042915",
            "telephone_number": "310-829-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINAL REHABILITATION MEDICAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPINAL REHABILITATION MEDICAL GROUP, INC.",
        "enumeration_date": "2011-04-21",
        "last_updated": "2011-04-21",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-829-2225",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; 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.