Friendly OB GYN Medical Group Inc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

G71778

Legal business name

FRIENDLY OB GYN MEDICAL GROUP INC

Practice address

12810 Heacock St Ste B105
Moreno Valley, CA 92553-3171

Phone

(951) 485-9133

NPI assigned

Aug 26, 2005

Organization subpart

No

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

Authorized official

Name

Sudhakar Dixit, MDNPI 1518950377

Title

Owner

Phone

(951) 485-9133

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sudhakar Dixit, MD

  • Obstetrics & Gynecology Physician
  • Moreno Valley, CA
  • NPI 1518950377
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389571200000",
    "number": "1821081647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12810 HEACOCK ST STE B105",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533171",
            "telephone_number": "951-485-9133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12810 HEACOCK ST STE B105",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533171",
            "telephone_number": "951-485-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIENDLY OB GYN MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2014-01-13",
        "status": "A",
        "authorized_official_last_name": "DIXIT",
        "authorized_official_first_name": "SUDHAKAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-485-9133",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": "G71778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0089982",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0089980",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0089981",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael H. French, D.O.
• Lauren Friar, PA-C
• Christina Frias
• Yuri Crystal Frias
• Alexander Friedman, D.O.
• Katherine Ann Froehlich, DNAP, RN, CRNA
• Fuentes Care Homes LLC
• Teresa Fuentes, NP
• Ciara Catherine Bautista Fulgar, DO
• Calvin Fung, DO

• Obstetrics & Gynecology Physician in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.