Organization Active NPI

Empowerme Medical Group California, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Granite Bay, CA
National Provider Identifier
1861223166
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
EMPOWERME MEDICAL GROUP CALIFORNIA, PC
Practice address
9747 Sierra College Blvd
Granite Bay, CA 95746-6320
Phone
(877) 367-9772
NPI assigned
Aug 9, 2024
Last updated
Aug 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Authorized official

Name
David Church
Title
VP Finance
Phone
(618) 972-5228

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

9747 Sierra College Blvd
Granite Bay, CA 95746-6320

Mailing address

1335 Strassner Dr
Brentwood, MO 63144-1872
Phone (877) 367-9772

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1861223166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 STRASSNER DR",
            "city": "BRENTWOOD",
            "state": "MO",
            "postal_code": "631441872",
            "telephone_number": "877-367-9772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9747 SIERRA COLLEGE BLVD",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957466320",
            "telephone_number": "877-367-9772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWERME MEDICAL GROUP CALIFORNIA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "618-972-5228"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite Bay, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.