Imideology Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

IMIDEOLOGY INC

Practice address

3940 Louis Rd
Palo Alto, CA 94303-4544

Phone

(203) 233-0116

NPI assigned

Dec 29, 2023

Organization subpart

No

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

Authorized official

Name

Jin Lee

Title

Ceo

Phone

(203) 233-0116

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1703808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703808000000",
    "number": "1760251888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3940 LOUIS RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943034544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3940 LOUIS RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943034544",
            "telephone_number": "203-233-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMIDEOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-29",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "203-233-0116"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.