West County Medical Clinic

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

License

19-037 Issued in CA

Legal business name

WEST COUNTY MEDICAL CLINIC

Practice address

100 E Market Street
Long Beach, CA 90805-5924

Phone

(562) 428-4222

Fax

(562) 428-0372

NPI assigned

May 23, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Pramesh Prakash Sharma

Title

Sr V P

Phone

(661) 254-6630

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Opioid treatment program

Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• American Health Services LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Hawaiian Gardens, CA
  • NPI 1861562068

  Member Of

  NPD member

Practitioners 3

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

• Kenneth Kambiz Gheysar, M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Laguna Hills, CA
  • NPI 1609992171
  NPD
• Michael Yadegari, M.D

  • Gastroenterology Physician
  • Van Nuys, CA
  • NPI 1023293016
  NPD
• Henry Kenneth Fisher, M.D.

  • Pulmonary Disease Physician
  • Casper, WY
  • NPI 1063517506
  NPD

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580947200000",
    "number": "1851501233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26460 SUMMIT CIR",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913502991",
            "telephone_number": "661-254-6630",
            "fax_number": "661-254-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E MARKET STREET",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908055924",
            "telephone_number": "562-428-4222",
            "fax_number": "562-428-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COUNTY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "PRAMESH",
        "authorized_official_middle_name": "PRAKASH",
        "authorized_official_title_or_position": "SR V P",
        "authorized_official_telephone_number": "661-254-6630",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "CA",
            "license": "19-037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADPA",
            "identifier": "1946",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE NTP LICENSE",
            "identifier": "19-037",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• West Coast Healthy Living Center
• West Coast Healthy Living Outreach
• West Coast Orthopedics Inc
• West Coast Physicians Group, Inc
• West County Medical
• West County Medical Corp-Non Profit
• West County Medical Corporation
• West County Medical Corporation
• West East Acupuncture Inc
• West Ocean Medical Group, Inc

• Methadone Clinic in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Methadone Clinic in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.