Pegasus Medical Group, Inc.

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

PEGASUS MEDICAL GROUP, INC.

Practice address

2151 E Palmdale Blvd
Palmdale, CA 93550-4037

Phone

(661) 273-3222

Fax

(661) 947-7269

NPI assigned

May 3, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Lori Gabbard

Title

Director of Operations

Phone

(661) 273-3222

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609088707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504037",
            "telephone_number": "661-273-3222",
            "fax_number": "661-947-7269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504037",
            "telephone_number": "661-273-3222",
            "fax_number": "661-947-7269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEGASUS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GABBARD",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "661-273-3222",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Pawliwec, MD
• Isabel N Payne
• Vajezatha Zaccai Payne, LCSW
• Jennifer Lynn Pearce, RDN
• Patricia Pedroza
• Gilbert Pelayo, F.N.P
• Elvia Lucema Pena, RN
• Josefina Pena
• Sandy Pena, LCSW
• Yuchi Peter Peng, MD

• Health Maintenance Organization in Palmdale, CA
• Providers in Palmdale, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.