San Joaquin Prime Care Medical Group Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A43893 Issued in CA

Legal business name

SAN JOAQUIN PRIME CARE MEDICAL GROUP INC.

Practice address

826 E Manning Ave
Reedley, CA 93654-2232

Phone

(559) 638-0400

Fax

(559) 638-0403

NPI assigned

Sep 12, 2007

Last updated

Apr 24, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly Burgins

Title

Billing Supervisor

Phone

(559) 783-1181

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429833600000",
    "number": "1710172721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E PINE ST",
            "city": "EXETER",
            "state": "CA",
            "postal_code": "932211838",
            "telephone_number": "559-592-2134",
            "fax_number": "559-592-5017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 E MANNING AVE",
            "city": "REEDLEY",
            "state": "CA",
            "postal_code": "936542232",
            "telephone_number": "559-638-0400",
            "fax_number": "559-638-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOAQUIN PRIME CARE MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2015-04-24",
        "status": "A",
        "authorized_official_last_name": "BURGINS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "559-783-1181"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A43893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM53947F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0084784",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Roman, LVN
• Benjamin Rosner, MD
• Agustin Rubio, M.D.
• Magdalena Ruiz, FNP
• Ana Zuguey Salinas Cortes I
• Sanare Wound Care Medical Group
• Eileen Maxine Sandoval, LMFT
• Veerpal Kaur Sangha
• Roberto R Santoyo, P.A.
• Aeah F Saphieh

• Family Medicine Physician in Reedley, CA
• Providers in Reedley, 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 Apr 24, 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.