Baldwin Park Medical Clinic Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BALDWIN PARK MEDICAL CLINIC INC

Practice address

14051 Ramona Pkwy
Baldwin Park, CA 91706-4114

Phone

(626) 960-3753

Fax

(626) 962-9866

NPI assigned

May 31, 2013

Last updated

Apr 23, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Terry M Lee, M.D.NPI 1184796104

Title

President

Phone

(626) 960-3753

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Terry M Lee, M.D.

  • Family Medicine Physician
  • Monterey Park, CA
  • NPI 1184796104
  Medicare reassignment Care Compare group NPD Authorized official
• Edielyn Layag Quijano, NP

  • Family Nurse Practitioner
  • Baldwin Park, CA
  • NPI 1982974705
  Medicare reassignment Care Compare group NPD
• Jennifer Vida Diego Callueng, NP

  • Family Nurse Practitioner
  • Baldwin Park, CA
  • NPI 1518589944
  Medicare reassignment NPD
• Jessica Wu, FNP-C

  • Family Nurse Practitioner
  • Monterey Park, CA
  • NPI 1265972301
  Medicare reassignment NPD
• Samia Gerets Ateia, MD

  • Pediatrics Physician
  • Baldwin Park, CA
  • NPI 1124101316
  NPD (past)

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

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587600000000",
    "number": "1750728663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14051 RAMONA PKWY",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917064114",
            "telephone_number": "626-960-3753",
            "fax_number": "626-962-9866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14051 RAMONA PKWY",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917064114",
            "telephone_number": "626-960-3753",
            "fax_number": "626-962-9866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALDWIN PARK MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-31",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-960-3753",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G62452",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G62452",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Baldwin Park Family Dental
• Baldwin Park Hospice Inc
• Baldwin Park Medical Center
• Baldwin Park Medical Center Inc
• Baldwin Park Medical Center, Inc.
• Baldwin Park Unified School District
• Gerardo Baltierra
• Balwin Park Medical Group, Inc.
• Mira Bansil, PA
• Ariana Malagon Banuelos, MD

• Family Medicine Physician in Baldwin Park, CA
• Providers in Baldwin Park, 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 Apr 23, 2020; 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.