Robert G Pugach MD Inc

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

A41822 Issued in CA

Legal business name

ROBERT G PUGACH MD INC

Practice address

3801 Katella Ave
#110
Los Alamitos, CA 90720

Phone

(562) 594-0860

Fax

(562) 594-9010

NPI assigned

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

Robert Glenn Pugach, MD

Title

President

Phone

(562) 594-0860

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pacific Coast Urology Medical Center Inc Doing business as

Locations

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992884738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 KATELLA AVE",
            "address_2": "#110",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "90720",
            "telephone_number": "562-594-0860",
            "fax_number": "562-594-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 KATELLA AVE",
            "address_2": "#110",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "90720",
            "telephone_number": "562-594-0860",
            "fax_number": "562-594-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT G PUGACH MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PUGACH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-594-0860",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "A41822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A418220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Coast Urology Medical Center Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Urology Physician in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.