MC Ibanez Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A64505 Issued in CA

Legal business name

MC IBANEZ MEDICAL CORPORATION

Practice address

8100 Timberlake Way
Suite C
Sacramento, CA 95823-5409

Phone

(916) 681-5000

Fax

(916) 681-5887

NPI assigned

May 22, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Caesar Locsin Ibanez

Title

Ceo

Phone

(916) 681-5000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PRIMELIFE MEDICAL GROUP, INC. Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Marcelina Gutierrez Ibanez, M.D.

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1295917417
  Medicare reassignment

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337558400000",
    "number": "1629022561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 TIMBERLAKE WAY",
            "address_2": "SUITE C",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235409",
            "telephone_number": "916-681-5000",
            "fax_number": "916-681-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 TIMBERLAKE WAY",
            "address_2": "SUITE C",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235409",
            "telephone_number": "916-681-5000",
            "fax_number": "916-681-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MC IBANEZ MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2012-05-21",
        "status": "A",
        "authorized_official_last_name": "IBANEZ",
        "authorized_official_first_name": "CAESAR",
        "authorized_official_middle_name": "LOCSIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-681-5000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A64505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A645050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIMELIFE MEDICAL GROUP, INC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maria Josefina Mba Wright, MD
• Pamela Mbolo
• MBS Mobility LLC
• Judy Mbure
• Lilian Mbuthia
• Chase Austin McAfee, MA
• Jailynn McAfee
• Rachael Dianne McAfee, PA-C
• Susan McAfee
• Corrine Elissa McAlister, LCSW

• 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 May 21, 2012; 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.