BALWIN PARK MEDICAL GROUP, INC. (NPI# 1013515287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013515287 |
| Entity Type | Organization |
| Organization Name | BALWIN PARK MEDICAL GROUP, INC. |
| Other Organization Name | BALDWIN PARK MEDICAL GROUP, INC. |
| Practice Address |
14652 Pacific Ave Baldwin Park CA 91706-5333 |
| Practice Telephone | 6266088202 |
| Mailing Telephone | 6266088202 |
| Enumeration Date | 2020-10-11 |
| Last Update Date | 2020-11-05 |
| Authorized Official Name | ERRAJITH BERTRAND R DE SILVA (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7146732603 |
| Authorized Official Credential | MEDICAL DOCTOR |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Baldwin Park Medical Group, Inc. | Doing Business As Name - Organization |
| Street Address |
14652 PACIFIC AVE |
| City | BALDWIN PARK |
| State | CA |
| Zip Code | 91706-5333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265875975 | Erica J Taylor | Marriage & Family Therapist | 14652 Pacific Ave, Baldwin Park, CA 91706-5333 | 2013-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588206700 | Sistine Manor Inc | Assisted Living Facility | 12755 Torch St, Baldwin Park, CA 91706 | 2019-10-09 |
| 1891268850 | Rodriguez Cruz Dental, Inc. | Clinic/Center | 14323 Ramona Blvd., Baldwin Park, CA 91706 | 2019-01-02 |
| 1942788633 | Desiree Montoya | Counselor | 13030 Ramona Blvd Unit 65, Baldwin Park, CA 91706 | 2018-08-03 |
| 1861978215 | Cassidy Alyse Harton | Counselor | 4514 Grace Ave, Baldwin Park, CA 91706 | 2018-07-18 |
| 1881146751 | Melissa Valenzuela | Nurse Practitioner | 14362 E. Ramona Blvd, Baldwin Park, CA 91706 | 2016-10-26 |
| 1629524228 | Trosclair Seals | Counselor | 36 S Kinneola Ave, Pasad, CA 91706 | 2016-09-01 |
| 1487025854 | Janeth Estevez | Case Manager/Care Coordinator | 14123 Masline St, Baldwin Park, CA 91706 | 2015-10-12 |
| 1932579570 | Bls Dental Group | Clinic/Center | 14032 Ramona Blvd., Bladwin Park, CA 91706 | 2015-09-25 |
| 1487068748 | Prakash P. Patel D.ds Inc | Dentist | 4138 N. Maine Ave, Suite N-3, Baldwin Park, CA 91706 | 2014-06-16 |
| 1295076891 | Julia Lauria | Rehabilitation Practitioner | 11317 Rmaona Blvd., Ste.c, Irwindale, CA 91706 | 2013-03-06 |
| Find all providers in zip 91706 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770728636 | Carcamo Medical Corporation | Family Medicine | 14362 Ramona Blvd., Baldwin Park, CA 91706-6241 | 2008-12-08 |
| 1316168636 | Jyh C. Chang Md, Professional Corp. | Family Medicine | 4318 Maine Ave, Baldwin Park, CA 91706-3306 | 2007-05-02 |
| 1710057203 | Rodolfo Vallejos Punzalan | Family Medicine | 1630 Puente Ave, Baldwin Park, CA 91706-5952 | 2006-11-09 |
| 1225129281 | Marvin E Urbina | Family Medicine | 14342 Ramona Blvd, Baldwin Park, CA 91706-3241 | 2006-09-27 |
| 1477167062 | Clinica Del Pueblo Carcamo A Medical Corporation | Family Medicine | 14650 Pacific Ave, Baldwin Park, CA 91706-5333 | 2020-09-02 |
| 1760906507 | La Providencia Ipa, Inc. | Family Medicine | 14342 Ramona Blvd, Baldwin Park, CA 91706-3241 | 2017-08-02 |
| 1104225978 | Steven Lam | Family Medicine | 1011 Baldwin Park Blvd, Baldwin Park, CA 91706-5806 | 2014-08-18 |
| 1528488723 | Arash Khalili | Family Medicine | 1011 Baldwin Park Blvd, Baldwin Park, CA 91706-5806 | 2014-04-26 |
| 1700200763 | Clarissa Menard | Family Medicine | 1011 Baldwin Park Blvd, Baldwin Park, CA 91706-5806 | 2014-02-11 |
| 1669789715 | Rosemary D Soliz | Family Medicine | 1011 Baldwin Park Blvd, Baldwin Park, CA 91706-5806 | 2010-09-10 |
| Find all providers in BALDWIN PARK | ||||
| City | BALDWIN PARK |
| Zip Code | 91706 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.