NPIMap

Organization Active NPI

Victory Olive Medical Group, Inc.

  • Specialist
  • Burbank, CA
National Provider Identifier
1730498619
Registry record updated Sep 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A64760 Issued in CA
Legal business name
VICTORY OLIVE MEDICAL GROUP, INC.
Practice address
191 S Buena Vista St
370
Burbank, CA 91505-4554
Phone
(818) 558-7888
Fax
(818) 558-7818
NPI assigned
Sep 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2010

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

Authorized official

Name
Lin Gehua Lemay, M.D.
Title
Doctor
Phone
(818) 558-7888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X A64760 CA Primary

Addresses

Primary practice location

191 S Buena Vista St
370
Burbank, CA 91505-4554

Mailing address

241 W Olive Ave
Burbank, CA 91502-1825
Phone (818) 558-7888

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285545600000",
    "number": "1730498619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 W OLIVE AVE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021825",
            "telephone_number": "818-558-7888",
            "fax_number": "818-558-7818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST",
            "address_2": "370",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054554",
            "telephone_number": "818-558-7888",
            "fax_number": "818-558-7818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY OLIVE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-27",
        "last_updated": "2010-09-27",
        "status": "A",
        "authorized_official_last_name": "LEMAY",
        "authorized_official_first_name": "LIN",
        "authorized_official_middle_name": "GEHUA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "818-558-7888",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A64760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; 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.