Organization Active NPI

Hanford Primary Care Medical Associates, Inc.

  • Family Medicine Physician
  • Visalia, CA
National Provider Identifier
1770809055
Registry record updated Oct 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A85143 Issued in CA
Legal business name
HANFORD PRIMARY CARE MEDICAL ASSOCIATES, INC.
Practice address
5109 W Goshen Ave
Visalia, CA 93291-8620
Phone
(559) 740-7989
Fax
(559) 740-7952
NPI assigned
Apr 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2014

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

Authorized official

Name
Daria Majzoubi, MDNPI 1811941628
Title
Ceo
Phone
(559) 740-7989

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X A85143 CA Primary
Durable Medical Equipment & Medical Supplies 332B00000X CA

Addresses

Primary practice location

5109 W Goshen Ave
Visalia, CA 93291-8620

Mailing address

5109 W Goshen Ave
Visalia, CA 93291-8620
Phone (559) 740-7989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101012001216 CA Part B Supplier - Clinic/Group Practice 1355533068 Receives reassigned benefits from 1 practitioner
Practice locations: Visalia, CA

National Provider Directory

National Provider Directory

Locations

5109 W Goshen Ave
Visalia, CA 93291
Phone (559) 740-7989

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412899200000",
    "number": "1770809055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5109 W GOSHEN AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932918620",
            "telephone_number": "559-740-7989",
            "fax_number": "559-740-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5109 W GOSHEN AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932918620",
            "telephone_number": "559-740-7989",
            "fax_number": "559-740-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANFORD PRIMARY CARE MEDICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-12",
        "last_updated": "2014-10-10",
        "status": "A",
        "authorized_official_last_name": "MAJZOUBI",
        "authorized_official_first_name": "DARIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-740-7989",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A85143",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.