First Integrated Care Medical Group Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A38544 Issued in CA

Legal business name

FIRST INTEGRATED CARE MEDICAL GROUP INC

Practice address

1339 W Willow St
Long Beach, CA 90810-3116

Phone

(562) 492-6698

Fax

(562) 492-9553

NPI assigned

Oct 20, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Elnora T Tabila, RN

Title

Office Manager

Phone

(562) 492-6698

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Rodolfo T. Tabila, M.D.

  • Family Medicine Physician
  • Long Beach, CA
  • NPI 1962538181
  Medicare reassignment
• Renee Pagal Alsisto-Pagatpatan, PA-C

  • Physician Assistant
  • Long Beach, CA
  • NPI 1447491980
  NPD (past)

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614902400000",
    "number": "1720077852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1339 W WILLOW ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908103116",
            "telephone_number": "562-492-6698",
            "fax_number": "562-492-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1339 W WILLOW ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908103116",
            "telephone_number": "562-492-6698",
            "fax_number": "562-492-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST INTEGRATED CARE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "TABILA",
        "authorized_official_first_name": "ELNORA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "562-492-6698",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A38544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A385440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• First Care Multispecialty Medical Group, Inc.
• First Choice Administrators, Inc.
• First Choice Medical Associates Inc
• First Choice Physician Partners
• First Choice Physician Partners
• First Response Healthcare Inc., Doctor of Nursing Practice
• First to Assist, LLC.
• Sandy D First, NP
• Firstsight Vision Servces, Inc.
• Firstsight Vision Services, Inc.

• Family Medicine Physician in Long Beach, CA
• Providers in Long Beach, 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 Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.