Zacoalco Medical Group Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G75144 Issued in CA

Legal business name

ZACOALCO MEDICAL GROUP INC

Practice address

1414 E Florence Ave
Los Angeles, CA 90001

Phone

(323) 588-1383

Fax

(323) 588-2339

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Raymond Menchaca, MDNPI 1851339089

Title

Medical Director

Phone

(323) 588-1383

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Zacoalco Medical Group Inc

  • Family Medicine Physician
  • Bakersfield, CA
  • NPI 1679626170

  O20050606001247

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Zacoalco Medical Group Inc

  • Family Medicine Physician
  • Bakersfield, CA
  • NPI 1679626170
  NPPES parent name

Practitioners 7

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

• Raymond M Menchaca, M.D.

  • Family Medicine Physician
  • Fillmore, CA
  • NPI 1851339089
  NPD Authorized official
• Ricardo E Chambi, MD

  • General Practice Physician
  • Huntington Park, CA
  • NPI 1518905181
  NPD
• Saul De la Rosa, PA PHYSICIAN ASSISTA

  • Physician Assistant
  • Los Angeles, CA
  • NPI 1669554705
  NPD
• Edgar Leonardo Farias

  • Student in an Organized Health Care Education/Training Program
  • Los Angeles, CA
  • NPI 1992468623
  NPD
• Ruth Paez, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Monterey Park, CA
  • NPI 1609104470
  NPD
• Adrian Quiroz Rojas, PAC

  • Physician Assistant
  • Oxnard, CA
  • NPI 1902826910
  NPD
• Cynthia Francisco, NP

  • Family Nurse Practitioner
  • Mountain View, CA
  • NPI 1376912535
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520553600000",
    "number": "1750442836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 E FLORENCE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90001",
            "telephone_number": "323-588-1383",
            "fax_number": "323-588-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 E FLORENCE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90001",
            "telephone_number": "323-588-1383",
            "fax_number": "323-588-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZACOALCO MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2018-03-09",
        "status": "A",
        "authorized_official_last_name": "MENCHACA",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "323-588-1383",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G75144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0080240",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0080241",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Wendy Zachary, M.D.
• Paige Kathleen Dekker Zachary, MD
• Latiera Zachery
• Corinne Elizabeth Zachry
• Lacey Zack, M.D.
• Zacoalco Urgent Care Center Inc
• Arash Zad-Behtooie
• Gabriel Zada, M.D.
• Sherehan Zada, MD
• Ray Zadegan, MD

• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, 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 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.