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GAGE MEDICAL CLINIC INC NPI 1114053279


NPI Information

NPI: 1114053279
Provider Name: GAGE MEDICAL CLINIC INC

Doing Business As: PACOIMA MEDICAL CENTER

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D1060354

Address:
13563 VAN NUYS BLVD
PACOIMA, CA
ZIP 91331
Phone: (818) 890-5300
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GAGE MEDICAL CLINIC INC is a family medicine in Pacoima, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. GAGE MEDICAL CLINIC INC NPI is 1114053279. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Pacoima Medical Center.

The provider's business location address is:

13563 VAN NUYS BLVD
PACOIMA, CA
ZIP 91331-029
Phone: (818) 890-5300
Fax: (818) 890-0880

The provider's authorized official is Odilia Walsh .
The authorized official title is Administrator and has the following contact phone number (562) 706-2433.

The CLIA number assigned to this NPI record is 05D1060354 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/25/2007 and was last updated on 2/9/2024.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineG29047CALIFORNIANo
2207V00000XObstetrics & GynecologyA67946CALIFORNIANo
3261QM1300XClinic/CenterMulti-SpecialtyNo
4207Q00000XFamily MedicineA47748CALIFORNIAYes

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: 4/28/2024

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