Jose de Guzman Co Ting MD Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A38825 Issued in CA

Legal business name

JOSE DE GUZMAN CO TING MD INC

Doing business as

Echo Park Family Medical Clinic

Practice address

1160 N Logan Street
Los Angeles, CA 90026

Phone

(213) 250-7069

Fax

(213) 250-7520

NPI assigned

Aug 4, 2006

Last updated

Apr 19, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jose De Guzman Co Ting, MD

Title

President

Phone

(213) 250-7069

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Echo Park Family Medical Clinic Doing business as

Locations

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334793600000",
    "number": "1942218730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 CAMINO SAN RAFAEL",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91206",
            "telephone_number": "818-952-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 N LOGAN STREET",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90026",
            "telephone_number": "213-250-7069",
            "fax_number": "213-250-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSE DE GUZMAN CO TING MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2012-04-19",
        "status": "A",
        "authorized_official_last_name": "CO TING",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "DE GUZMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-250-7069",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A38825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A388250",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHDP",
            "identifier": "00A388250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Echo Park Family Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.