Organization Active NPI

Multispeciality and Occupational Injury Medical Center a Med Corp

  • Internal Medicine Physician
  • Corona, CA
National Provider Identifier
1831408061
Registry record updated Mar 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A68736 Issued in CA
Legal business name
MULTISPECIALITY AND OCCUPATIONAL INJURY MEDICAL CENTER A MED CORP
Practice address
703 Magnolia Ave
Corona, CA 92879-3118
Phone
(951) 340-2178
Fax
(951) 340-2478
NPI assigned
Oct 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2011

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

Authorized official

Name
Stella Ara
Title
Office Manager/Biller
Phone
(951) 340-2178

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A68736 CA Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A70230 CA

Addresses

Primary practice location

703 Magnolia Ave
Corona, CA 92879-3118

Mailing address

703 Magnolia Ave
Corona, CA 92879-3118
Phone (951) 340-2178

Other identifiers 1

IdentifierTypeStateIssuer
00A687360MedicaidCA

National Provider Directory

National Provider Directory

Locations

703 Magnolia Ave
Corona, CA 92879
Phone (951) 340-2178

NPI Registry JSON

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

{
    "created_epoch": "1286323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299456000000",
    "number": "1831408061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 MAGNOLIA AVE",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793118",
            "telephone_number": "951-340-2178",
            "fax_number": "951-340-2478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAGNOLIA AVE",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793118",
            "telephone_number": "951-340-2178",
            "fax_number": "951-340-2478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULTISPECIALITY AND OCCUPATIONAL INJURY MEDICAL CENTER A MED CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-06",
        "last_updated": "2011-03-07",
        "status": "A",
        "authorized_official_last_name": "ARA",
        "authorized_official_first_name": "STELLA",
        "authorized_official_title_or_position": "OFFICE MANAGER/BILLER",
        "authorized_official_telephone_number": "951-340-2178"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A68736",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A70230",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A687360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.