NPIMap

Organization Active NPI

Prime Mobile Physicians Network, Inc

  • General Practice Physician
  • Valencia, CA
National Provider Identifier
1679190664
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PRIME MOBILE PHYSICIANS NETWORK, INC
Practice address
28212 Kelly Johnson Pkwy Ste 200
Valencia, CA 91355-5090
Phone
(213) 228-3538
Fax
(818) 356-4380
NPI assigned
Jun 25, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Authorized official

Name
Izuchukwu Okpara, MD
Title
President & Ceo
Phone
(213) 228-3538

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

28212 Kelly Johnson Pkwy Ste 200
Valencia, CA 91355-5090

Mailing address

25044 Peachland Ave Ste 209
Newhall, CA 91321-5751
Phone (613) 837-1366

National Provider Directory

National Provider Directory

Locations

27674 Newhall Ranch Rd
Ste C85
Valencia, CA 91355
Phone (661) 561-8444

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603929600000",
    "number": "1679190664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25044 PEACHLAND AVE STE 209",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913215751",
            "telephone_number": "613-837-1366",
            "fax_number": "818-356-4380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28212 KELLY JOHNSON PKWY STE 200",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913555090",
            "telephone_number": "213-228-3538",
            "fax_number": "818-356-4380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME MOBILE PHYSICIANS NETWORK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-25",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "OKPARA",
        "authorized_official_first_name": "IZUCHUKWU",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "213-228-3538",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.