NPIMap

Organization Active NPI

Medicina Familiar

  • General Practice Physician
  • Canoga Park, CA
National Provider Identifier
1972694180
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A41311 Issued in CA
Legal business name
MEDICINA FAMILIAR
Practice address
20440 Sherman Way
Canoga Park, CA 91306
Phone
(818) 346-2395
Fax
(818) 346-4591
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Authorized official

Name
Jose Manuel Gonzalez-Diaz, MD
Title
Owner
Phone
(818) 346-2395

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X A41311 CA Primary

Addresses

Primary practice location

20440 Sherman Way
Canoga Park, CA 91306

Mailing address

20440 Sherman Way
Canoga Park, CA 91306
Phone (818) 346-2395

Other identifiers 1

IdentifierTypeStateIssuer
GR6086182MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Medicina Familiar3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1972694180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20440 SHERMAN WAY",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "91306",
            "telephone_number": "818-346-2395",
            "fax_number": "818-346-4591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20440 SHERMAN WAY",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "91306",
            "telephone_number": "818-346-2395",
            "fax_number": "818-346-4591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINA FAMILIAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ-DIAZ",
        "authorized_official_first_name": "JOSE MANUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-346-2395",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A41311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR6086182",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canoga Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.