Kolvita Family Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A74559 Issued in CA

Legal business name

KOLVITA FAMILY MEDICAL GROUP, INC.

Practice address

25982 Pala
Ste. 180
Mission Viejo, CA 92691-6719

Phone

(949) 600-8990

Fax

(949) 600-8998

NPI assigned

Jan 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Linda Marlene Bolling, M.D.

Title

Owner

Phone

(949) 600-8990

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 3

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

• Linda Marlene Bolling Davis, M.D.

  • Family Medicine Physician
  • Mission Viejo, CA
  • NPI 1871664987
  Medicare reassignment Care Compare group NPD
• Matthew A Zeller, D.O.

  • Family Medicine Physician
  • Mission Viejo, CA
  • NPI 1700970332
  Medicare reassignment Care Compare group NPD
• Stephanie Shea Hawkins, MD

  • Family Medicine Physician
  • Mission Viejo, CA
  • NPI 1285792507
  NPD (past)

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

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348790400000",
    "number": "1932255148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25982 PALA",
            "address_2": "STE. 180",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916719",
            "telephone_number": "949-600-8990",
            "fax_number": "949-600-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25982 PALA",
            "address_2": "STE. 180",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916719",
            "telephone_number": "949-600-8990",
            "fax_number": "949-600-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOLVITA FAMILY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-28",
        "last_updated": "2012-09-28",
        "status": "A",
        "authorized_official_last_name": "BOLLING",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "MARLENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-600-8990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A74559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mouriann Kleeh Kleeh
• Timothy Lee Klein-Mohr, PTA
• Lisa Marie Klimpel, CPNP
• Jason W Knott, PA
• Hee Yon Koh, DMD
• Komi Optical, Inc.
• Haley Caitlyn Kong
• Joseph M Konstantarakis, M.D.
• Kool Living Inc.
• Kool Living, Inc.

• Family Medicine Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.