Ideal Mobile MD Medical Group, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

IDEAL MOBILE MD MEDICAL GROUP, INC

Practice address

9550 Warner Ave Ste 250
Fountain Valley, CA 92708-2842

Phone

(657) 217-4500

Fax

(627) 217-4501

NPI assigned

Jul 30, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Julie D Dong

Title

Secretary

Phone

(657) 217-4500

Specialties & licenses 1

Addresses

Other names 1

• Ideal IPA Doing business as

Locations

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1750110672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16027 BROOKHURST ST STE I-109",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927081551",
            "telephone_number": "657-217-4500",
            "fax_number": "657-217-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 WARNER AVE STE 250",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082842",
            "telephone_number": "657-217-4500",
            "fax_number": "627-217-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL MOBILE MD MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "DONG",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "657-217-4500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ideal IPA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.