Professional Advantage Medical Group

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

G87090 Issued in CA

Legal business name

PROFESSIONAL ADVANTAGE MEDICAL GROUP

Practice address

1041 E Yorba Linda Blvd
Suite 203
Placentia, CA 92870-3728

Phone

(714) 985-9110

Fax

(714) 985-9053

NPI assigned

Oct 19, 2015

Organization subpart

No

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

Authorized official

Name

John Gambol

Title

C.E.O

Phone

(850) 233-2228

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446163200000",
    "number": "1639540560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38713 TIERRA SUBIDA AVE",
            "address_2": "SUITE 200-315",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935514562",
            "telephone_number": "850-233-2228",
            "fax_number": "714-985-9053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 E YORBA LINDA BLVD",
            "address_2": "SUITE 203",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928703728",
            "telephone_number": "714-985-9110",
            "fax_number": "714-985-9053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ADVANTAGE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-10-30",
        "status": "A",
        "authorized_official_last_name": "GAMBOL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "C.E.O",
        "authorized_official_telephone_number": "850-233-2228"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "G87090",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Precision Anesthesia Consultants Inc
• Robert Douglas Preijers
• Sara Priester, MA, CCC-SLP
• Primaytan, Inc.
• Prochi Inc
• Prometheus Family Medicine
• Prosperite Health
• Luanne Marie Pryor, PT
• Richard William Puls, LMFT
• Ryan Jacob Pulsifer

• General Practice Physician in Placentia, CA
• Providers in Placentia, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; 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.