NPIMap

Organization Active NPI

Clinica Medica Mi Pueblo, Medical Clinic,Inc

  • Primary Care Clinic/Center
  • Anaheim, CA
National Provider Identifier
1679824429
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CLINICA MEDICA MI PUEBLO, MEDICAL CLINIC,INC
Practice address
500 N Anaheim Blvd
Anaheim, CA 92805-2647
Phone
(714) 502-9022
Fax
(714) 999-2450
NPI assigned
Sep 19, 2012
Last updated
Sep 19, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2012

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

Authorized official

Name
Dr. Thomas J Magee, MD
Title
Owner
Phone
(323) 726-0333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

500 N Anaheim Blvd
Anaheim, CA 92805-2647

Mailing address

6055 E Washington Blvd
Suite 240
Commerce, CA 90040-2449
Phone (323) 726-0333

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1022504Clinica Medica Mi Pueblo Inc500 N Anaheim Blvd, Anaheim, CA 92805Certificate of waiverNov 14, 2027

National Provider Directory

National Provider Directory
Tax ID family
Clinica Medica Mi Pueblo Medical Clinic Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

500 N Anaheim Blvd
Anaheim, CA 92805
Phone (714) 502-9022

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348012800000",
    "number": "1679824429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6055 E WASHINGTON BLVD",
            "address_2": "SUITE 240",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900402449",
            "telephone_number": "323-726-0333",
            "fax_number": "323-726-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N ANAHEIM BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928052647",
            "telephone_number": "714-502-9022",
            "fax_number": "714-999-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA MEDICA MI PUEBLO, MEDICAL CLINIC,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-19",
        "last_updated": "2012-09-19",
        "status": "A",
        "authorized_official_last_name": "MAGEE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-726-0333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.