Medrecord

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

G24934 Issued in CA

Legal business name

MEDRECORD

Practice address

22182 Barton Rd
Grand Terrace, CA 92313-5033

Phone

(909) 800-0025

NPI assigned

Dec 26, 2011

Organization subpart

No

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

Authorized official

Name

Harold Pohang Luke, MD

Title

Chairman

Phone

(909) 800-0025

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1324857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324857600000",
    "number": "1811266521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11118",
            "address_2": "C/O HAROLD LUKE MD",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924231118",
            "telephone_number": "909-800-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22182 BARTON RD",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135033",
            "telephone_number": "909-800-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDRECORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-26",
        "last_updated": "2011-12-26",
        "status": "A",
        "authorized_official_last_name": "LUKE",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "POHANG",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "909-800-0025",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "G24934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G249341",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tina Marie Lusk, RN
• Cassandra A Mahan-Richards, M.D.
• Anwar Manasrah
• Vivian Nicole Martinez
• Margaret Kathleen McLeod, M.D.
• Sanjiwani Meharda, MD
• Carrie Meller
• Selyn Anika Quemuel Mendoza, A.A.
• Hosea Mercer
• Metro Anesthesia Group

• General Practice Physician in Grand Terrace, CA
• Providers in Grand Terrace, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2011; 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.