Irvine Physicians Medical Group, Inc.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A52971 Issued in CA

Legal business name

IRVINE PHYSICIANS MEDICAL GROUP, INC.

Practice address

3700 South St
Lakewood, CA 90712-1419

Phone

(800) 883-7243

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Danilo Jaravata, M.D.

Title

President

Phone

(800) 883-7243

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198972800000",
    "number": "1992890149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "800-883-7243",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 SOUTH ST",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121419",
            "telephone_number": "800-883-7243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRVINE PHYSICIANS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-12-30",
        "status": "A",
        "authorized_official_last_name": "JARAVATA",
        "authorized_official_first_name": "DANILO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-883-7243",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A52971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A529710",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2007; 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.