Pacific Rim Integrated Medical Group Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20A5137 Issued in CA

Legal business name

PACIFIC RIM INTEGRATED MEDICAL GROUP INC

Doing business as

Amitabha Medical Clinic

Practice address

7064 Corline CT
Suite a
Sebastopol, CA 95472-4528

Phone

(707) 829-5900

Fax

(707) 829-5282

NPI assigned

Sep 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Cheri Sue Quincy, DONPI 1790877330

Title

Ceo

Phone

(707) 542-4800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Amitabha Medical Clinic Doing business as

Locations

Practitioners 2

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

• Cheri Quincy, D.O.

  • Internal Medicine Physician
  • Santa Rosa, CA
  • NPI 1790877330
  NPD (past) Authorized official
• Jay H Callender, L.AC

  • Acupuncturist
  • Santa Rosa, CA
  • NPI 1215151675
  NPD (past)

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231200000000",
    "number": "1821283987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7064 CORLINE CT",
            "address_2": "SUITE A",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724528",
            "telephone_number": "707-829-5900",
            "fax_number": "707-829-5282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7064 CORLINE CT",
            "address_2": "SUITE A",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724528",
            "telephone_number": "707-829-5900",
            "fax_number": "707-829-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC RIM INTEGRATED MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2009-01-06",
        "status": "A",
        "authorized_official_last_name": "QUINCY",
        "authorized_official_first_name": "CHERI",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "707-542-4800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A5137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "ZZZ13019Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amitabha Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark E Olson, RPH
• Ryan Charles Olson, ND
• Sharon L Olson, D.O.
• Maria Iduvina Onofre, BACHELOR
• Shannon Wallace Ottens, LCSW
• Leslie Paige
• Palm Drive Health Care District
• Palm Drive Health Care District (Sonoma West Medical Center)
• Palm Drive Health Care District (Palm Drive Hospital)
• Palm Drive Health Care District

• Internal Medicine Physician in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Internal Medicine Physician in California

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