Eastern Medical Center Professional Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A65618 Issued in CA

Legal business name

EASTERN MEDICAL CENTER PROFESSIONAL MEDICAL CORPORATION

Practice address

2930 Eastern Ave
Sacramento, CA 95821-4210

Phone

(916) 972-8966

Fax

(916) 972-8916

NPI assigned

Nov 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Li Li, M.D.NPI 1710959523

Title

Ceo

Phone

(916) 972-8966

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Eastern Medical Center Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

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

• Li Li, M.D.

  • General Practice Physician
  • Sacramento, CA
  • NPI 1710959523
  Medicare reassignment Authorized official
• Kuldip Singh Gill, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Grass Valley, CA
  • NPI 1295882769
  Medicare reassignment
• Charles Shang, MD

  • Internal Medicine Physician
  • Grass Valley, CA
  • NPI 1104805902
  Medicare reassignment

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261526400000",
    "number": "1598093262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 EASTERN AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958214210",
            "telephone_number": "916-972-8966",
            "fax_number": "916-972-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 EASTERN AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958214210",
            "telephone_number": "916-972-8966",
            "fax_number": "916-972-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN MEDICAL CENTER PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-18",
        "last_updated": "2009-12-23",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "LI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-972-8966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A65618",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A83360",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A73749",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1134230220",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1912973520",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1710959523",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shanice Easter
• Theresa A Easter
• Tynisha Nicole Easter
• Elizabeth Easterbrook
• Eastern Medical Center
• Eastfield Ming Quong
• Eastfield Quan Ming Children and Family Services
• Stephen Eastman, LMFT
• Trisha A Eastman, PT
• Sarah Eastway

• Family Medicine Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.