In His Image Family Clinic, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A102441 Issued in CA

Legal business name

IN HIS IMAGE FAMILY CLINIC, INC

Practice address

18251 Roscoe Blvd
#105
Northridge, CA 91325-4200

Phone

(818) 718-0500

NPI assigned

May 9, 2013

Organization subpart

No

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

Authorized official

Name

Joseph Samuel Meshriky, MD

Title

President

Phone

(818) 718-0500

Specialties & licenses 1

Addresses

Other names 1

• In His Image Family Clinic urgent care Other name

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368921600000",
    "number": "1992140446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18251 ROSCOE BLVD",
            "address_2": "105",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254200",
            "telephone_number": "818-718-0500",
            "fax_number": "818-718-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18251 ROSCOE BLVD",
            "address_2": "#105",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254200",
            "telephone_number": "818-718-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN HIS IMAGE FAMILY CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-09",
        "last_updated": "2013-05-19",
        "status": "A",
        "authorized_official_last_name": "MESHRIKY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-718-0500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A102441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "In His Image Family Clinic urgent care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Family Medicine Physician in Northridge, CA
• Providers in Northridge, 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 May 19, 2013; 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.