Clinica Medica Santa Isabel Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

G29345 Issued in CA

Legal business name

CLINICA MEDICA SANTA ISABEL INC

Practice address

1101 N Pacific Ave
Suite 104
Glendale, CA 91202-4313

Phone

(818) 552-5000

Fax

(818) 662-9605

NPI assigned

Jun 9, 2008

Last updated

Feb 25, 2009By 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. Howard Pfupajena, M.D.

Title

Owner

Phone

(818) 552-5000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235520000000",
    "number": "1821257437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N PACIFIC AVE",
            "address_2": "SUITE 104",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912024313",
            "telephone_number": "818-552-5000",
            "fax_number": "818-662-9605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N PACIFIC AVE",
            "address_2": "SUITE 104",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912024313",
            "telephone_number": "818-552-5000",
            "fax_number": "818-662-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA MEDICA SANTA ISABEL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2009-02-25",
        "status": "A",
        "authorized_official_last_name": "PFUPAJENA",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-552-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "G29345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Glendale, CA
• Providers in Glendale, 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 Feb 25, 2009; 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.