International Medical Group Inc, Home Healthcare & Hospice

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

INTERNATIONAL MEDICAL GROUP INC, HOME HEALTHCARE & HOSPICE

Practice address

14431 Ventura Blvd Ste 507
Sherman Oaks, CA 91423-2606

Phone

(323) 893-6632

Fax

(323) 798-8770

NPI assigned

Aug 25, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Anthony Vera, MD

Title

Ceo

Phone

(323) 893-6632

Specialties & licenses 8

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

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

• De Wayne D Dela Guerra, LVN

  • Licensed Vocational Nurse
  • Los Angeles, CA
  • NPI 1457695736
  NPD

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1710590245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14431 VENTURA BLVD STE 507",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914232606",
            "telephone_number": "323-893-6632",
            "fax_number": "323-798-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14431 VENTURA BLVD STE 507",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914232606",
            "telephone_number": "323-893-6632",
            "fax_number": "323-798-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL MEDICAL GROUP INC, HOME HEALTHCARE & HOSPICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-21",
        "status": "A",
        "authorized_official_last_name": "VERA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-893-6632",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HHA",
            "identifier": "A8660",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MARK@INTLMEDGRPINC.COM",
            "affiliation": "N",
            "endpointDescription": "OFF EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "14431 Ventura Blvd Ste 507",
            "city": "Sherman Oaks",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914232606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Community Based Hospice Care Agency in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.