Direct Care Medical Group, Inc.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A54433 Issued in CA

Legal business name

DIRECT CARE MEDICAL GROUP, INC.

Practice address

5901 W Olympic Blvd
Ste 300
Los Angeles, CA 90036-4667

Phone

(323) 756-1317

NPI assigned

Mar 2, 2016

Organization subpart

No

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

Authorized official

Name

Jack Azad, M.D.

Title

President

Phone

(323) 756-1317

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1568822690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 AVALON BLVD",
            "address_2": "STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900612866",
            "telephone_number": "323-756-1317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 W OLYMPIC BLVD",
            "address_2": "STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364667",
            "telephone_number": "323-756-1317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECT CARE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-02",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "AZAD",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-756-1317",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A54433",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A54433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandy Dip, RN, BSN
• Vincent Dip, MSN, APRN, PMHNP-BC
• Michael Dipaolo, PH.D.
• Dani Dipillo
• Charlie Grace Dirden
• Direct Imaging & Diagnostic Inc
• Direct Resolution
• Shari Vasquez Directo, M.D.
• Chloe Director
• Enrico J Dirienzo, MD

• Gastroenterology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.