Misco Medical Group Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A105161 Issued in CA

Legal business name

MISCO MEDICAL GROUP INC

Practice address

1125 Sir Francis Drake Blvd
Kentfield, CA 94904-1418

Phone

(877) 870-9301

Fax

(877) 882-0462

NPI assigned

May 25, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Jamison Derek Feramisco, M.D.NPI 1043410871

Title

Ceo/Owner

Phone

(877) 870-9301

Specialties & licenses 1

Addresses

Practitioners 2

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

• Jamison Derek Feramisco, MD, PHD

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1043410871
  NPD (past) Authorized official
• Shaker Itani, M.D.

  • Infectious Disease Physician
  • Los Angeles, CA
  • NPI 1538193826
  NPD (past)

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337904000000",
    "number": "1932469749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31566 RAILROAD CANYON RD",
            "address_2": "2-130",
            "city": "CANYON LAKE",
            "state": "CA",
            "postal_code": "925879446",
            "telephone_number": "877-870-9301",
            "fax_number": "877-882-0462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 SIR FRANCIS DRAKE BLVD",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041418",
            "telephone_number": "877-870-9301",
            "fax_number": "877-882-0462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISCO MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-25",
        "last_updated": "2012-05-25",
        "status": "A",
        "authorized_official_last_name": "FERAMISCO",
        "authorized_official_first_name": "JAMISON",
        "authorized_official_middle_name": "DEREK",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "877-870-9301",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A105161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara McCarroll, PH.D.
• Emily Kathryn McDonald
• Jeanette Meiguez
• Gabriel Metzger, PT, DPT
• Mindful Physical Therapy
• Sara A Morley, DPT
• Danya Hayward Moss, PSY.D.
• Movement Solutions Mobile Physical Therapy PC
• Caroline Mulder, MD
• Danila Musante, PHD

• Internal Medicine Physician in Kentfield, CA
• Providers in Kentfield, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; 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.