Amigo Industrial Medical Group

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

G84264 Issued in CA

Legal business name

AMIGO INDUSTRIAL MEDICAL GROUP

Practice address

6801 Coldwater Canyon Ave Ste 1E
North Hollywood, CA 91605-5167

Phone

(818) 759-2555

NPI assigned

Sep 5, 2007

Last updated

Sep 5, 2007By 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

Dr. Robere J Missirian, MD

Title

President

Phone

(818) 759-2555

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188950400000",
    "number": "1760676563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13029A VICTORY BLVD # 525",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916062925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 COLDWATER CANYON AVE STE 1E",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916055167",
            "telephone_number": "818-759-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMIGO INDUSTRIAL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A",
        "authorized_official_last_name": "MISSIRIAN",
        "authorized_official_first_name": "ROBERE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-759-2555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G84264",
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "G84264",
            "primary": false
        },
        {
            "code": "208U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Pharmacology",
            "state": "CA",
            "license": "G84264",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amour and Elia Dental Corporation (A&E Family Dental Care)

• Orthopaedic Surgery Physician in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.