Medipro Medical Group Inc

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

G77099 Issued in CA

Legal business name

MEDIPRO MEDICAL GROUP INC

Practice address

1829 E California Blvd
San Marino, CA 91108-1246

Phone

(310) 914-9150

Fax

(310) 914-9750

NPI assigned

Aug 17, 2006

Organization subpart

No

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

Authorized official

Name

Steven S Ho, M.D.

Title

Medical Doctor

Phone

(310) 914-9150

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Shahriar Ghodsian, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Thousand Oaks, CA
  • NPI 1699728410
  NPD (past)

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1952414328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 E CALIFORNIA BLVD",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911081246",
            "telephone_number": "310-914-9150",
            "fax_number": "310-914-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1829 E CALIFORNIA BLVD",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911081246",
            "telephone_number": "310-914-9150",
            "fax_number": "310-914-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIPRO MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "HO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "310-914-9150",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G77099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G770991",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Berry L. McCord, M.D.
• Carol Anne McCormick, NP
• Emily Hortenstine McDowell, PA-C
• Brent McMahon, PT
• Rochelle Medici, PHD
• Rita Fogata Mejia, RDN
• Mesa Advantage Medical Group
• Mike Nicholas Milinkovic, CHIROPRACTOR
• Robert M. Miller, PH.D.
• Karen I Minero, L.C.S.W.

• Nephrology Physician in San Marino, CA
• Providers in San Marino, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.