LAS PALMAS MEDICAL GROUP CORP. NPI 1013214568

NPI Information

NPI: 1013214568
Provider Name: LAS PALMAS MEDICAL GROUP CORP.
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 05D1078443

Address:
602 N EUCLID AVE
SUITE A
ONTARIO, CA
ZIP 91762
Phone: (909) 391-3448
Get Directions

LAS PALMAS MEDICAL GROUP CORP. is a general practice in Ontario, CA. LAS PALMAS MEDICAL GROUP CORP. NPI is 1013214568. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

602 N EUCLID AVE
SUITE A
ONTARIO, CA
ZIP 91762-224
Phone: (909) 391-3448

The provider's authorized official is Irma Lopez .
The authorized official title is Owner and has the following contact phone number (909) 391-3448.

The CLIA number assigned to this NPI record is 05D1078443 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/18/2011 and was last updated on 2/18/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		G57022	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	E56204	MEDICARE UPIN	CALIFORNIA
2	W17224	MEDICARE PIN	CALIFORNIA
3	1164503652	MEDICAID	CALIFORNIA
4	1770663551	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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