Blanco Family Medicine Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A0751476 Issued in CA

Legal business name

BLANCO FAMILY MEDICINE INC.

Practice address

380 W Badillo St
Covina, CA 91723-1827

Phone

(626) 915-3000

Fax

(626) 915-3004

NPI assigned

Mar 13, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Debra Blanco, PA-CNPI 1740372366

Title

Secretary

Phone

(626) 915-3000

Specialties & licenses 1

Addresses

Other names 1

• Blanco Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Debra Ann Blanco, PA-C

  • Physician Assistant
  • Ontario, CA
  • NPI 1740372366
  Medicare reassignment Authorized official
• Michael Andrew Woo-Ming, M.D.

  • Family Medicine Physician
  • Murrieta, CA
  • NPI 1558623371
  Medicare reassignment NPD

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

{
    "created_epoch": "1394668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394668800000",
    "number": "1922424902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 W BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231827",
            "telephone_number": "626-915-3000",
            "fax_number": "626-915-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 W BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231827",
            "telephone_number": "626-915-3000",
            "fax_number": "626-915-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLANCO FAMILY MEDICINE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-13",
        "last_updated": "2014-03-13",
        "status": "A",
        "authorized_official_last_name": "BLANCO",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "626-915-3000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A0751476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blanco Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Adib Husni Bitar, M.D.,
• Fahed Georgeos Bitar, M.D.
• Daniel Paul Black, RRW
• Soraya Blake
• Christina Blancas, LMFT
• Sophia Bland
• Paulina Shantel Blankenship
• Graciela Garcia Blissett
• Blu Alliance Counseling Center
• James A Blumenschein

• Primary Care Clinic/Center in Covina, CA
• Providers in Covina, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.