PK Medical Group Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A34329 Issued in CA

Legal business name

PK MEDICAL GROUP INC

Practice address

2549 Eastbluff Dr Ste B
Newport Beach, CA 92660-3599

Phone

(562) 733-9789

Fax

(818) 583-0054

NPI assigned

Jul 22, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Dosumu-Johnson, M.D.

Title

Ceo

Phone

(651) 252-3560

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446508800000",
    "number": "1538544325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2549 EASTBLUFF DR STE B",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926603599",
            "telephone_number": "562-733-9789",
            "fax_number": "818-583-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2549 EASTBLUFF DR STE B",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926603599",
            "telephone_number": "562-733-9789",
            "fax_number": "818-583-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PK MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-22",
        "last_updated": "2015-11-03",
        "status": "A",
        "authorized_official_last_name": "DOSUMU-JOHNSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-252-3560",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A34329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priya Pipariya
• Kara Pitkin
• Cameron John John Pitts
• Paulina Pizano-Pintor
• Allyson Jean Pizzo-Berkey, MD
• Kathiria Rosario Plascencia, FNP-BC
• Platinum Rehab Physical Therapy, PC (FIT Physiotherapy)
• Victoria Plewinski
• Sydney Hannah Podue
• Katie Pokorski

• General Practice Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.