Mga Medical Corporation

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

00046318 Issued in WA

Legal business name

MGA MEDICAL CORPORATION

Practice address

1016 Tacoma Ave
Sunnyside, WA 98944-2263

Phone

(509) 837-1500

NPI assigned

Apr 6, 2013

Organization subpart

No

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

Authorized official

Name

Lori Labrecque

Title

Accts MGR

Phone

(702) 453-3799

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1365206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365206400000",
    "number": "1770826901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 GAGE BLVD",
            "address_2": "#2121",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529605",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 TACOMA AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442263",
            "telephone_number": "509-837-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGA MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-06",
        "last_updated": "2013-04-06",
        "status": "A",
        "authorized_official_last_name": "LABRECQUE",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "ACCTS MGR",
        "authorized_official_telephone_number": "702-453-3799"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "00046318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LICENSE",
            "identifier": "00046318",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Joshua Mensonides
• Alfonso Meza
• Danna M Micech, FNP
• Mid-Valley Community Clinic, PLLC
• Maria Montelongo
• Patrick James Moran, DO
• Marissa L. Morfin, L.M.P.

• Hospitalist Physician in Sunnyside, WA
• Providers in Sunnyside, WA by specialty
• Hospitalist Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2013; 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.