Southland Med Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G18820 Issued in CA

Legal business name

SOUTHLAND MED GROUP

Practice address

1804 Garnet Ave
Suite 461
San Diego, CA 92109-3352

Phone

(619) 788-4570

NPI assigned

May 2, 2009

Organization subpart

No

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

Authorized official

Name

Michael B Bunim, MD

Title

Ceo

Phone

(619) 788-4570

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1241222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252972800000",
    "number": "1679707822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 GARNET AVE",
            "address_2": "SUITE 461",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 GARNET AVE",
            "address_2": "SUITE 461",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093352",
            "telephone_number": "619-788-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND MED GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-02",
        "last_updated": "2009-09-15",
        "status": "A",
        "authorized_official_last_name": "BUNIM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-788-4570",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G18820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; 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.