J Puangco M.D., Inc.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A91074 Issued in CA

Legal business name

J PUANGCO M.D., INC.

Practice address

21932 Annette Ave
Lake Forest, CA 92630-1811

Phone

(323) 375-4266

NPI assigned

Apr 5, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Jose Puangco, M.D.

Title

Ceo

Phone

(323) 375-4266

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333584000000",
    "number": "1609132448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21932 ANNETTE AVE",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301811",
            "telephone_number": "323-375-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21932 ANNETTE AVE",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301811",
            "telephone_number": "323-375-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J PUANGCO M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-05",
        "last_updated": "2012-04-05",
        "status": "A",
        "authorized_official_last_name": "PUANGCO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-375-4266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Electrodiagnostic Medicine",
            "state": "CA",
            "license": "A91074",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "CA",
            "license": "A91074",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A91074",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CA",
            "license": "A91074",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; 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.