PATHWAY MEDICAL GROUP (NPI# 1053708081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053708081 |
| Entity Type | Organization |
| Organization Name | PATHWAY MEDICAL GROUP |
| Practice Address |
21500 S. Pioneer Blve Suite 210 Hawaiian Gardens CA 90716 |
| Practice Telephone | 5623601556 |
| Practice Fax Number | 5627868629 |
| Mailing Telephone | 5623601556 |
| Mailing Fax Number | 5627868629 |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2015-04-16 |
| Authorized Official Name | GARY PHILLIP JACOBS (OWNER/DOCTOR) |
| Authorized Official Telephone | 5623601556 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | A42016 | CA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073858163 | Pathway Medical Group | Non-Pharmacy Dispensing Site | 7955 Westminster Blvd, Westminster, CA 92683-4001 | 2012-11-30 |
| Street Address |
21500 S. PIONEER BLVE SUITE 210 |
| City | HAWAIIAN GARDENS |
| State | CA |
| Zip Code | 90716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790032605 | Nancy Perez | Registered Nurse | 22009 Verne Ave, Hawaiian Gardens, CA 90716 | 2012-08-09 |
| 1194098210 | Ismael B. Nacino Md Inc | Anesthesiology | 21530 Pioneer Bl, Hawaiian Garden, CA 90716 | 2012-02-21 |
| 1326248832 | William Martin Wright | Counselor | 21520 S. Pioneer Blvd., Hawaiian Gardens, CA 90716 | 2007-07-23 |
| 1134341514 | Girish H Rami | Dentist | 12144 E Carson St, # E, Hawaiian Gardens, CA 90716 | 2007-05-03 |
| 1578684080 | Keun Chan Lee | Dentist | 12531 E Carson St, Hawaiian Gardens, CA 90716 | 2007-04-02 |
| 1154451995 | Consuelo Ramirez | Social Worker | 21520 S. Pioneer Bvld., Suite 110, Hawaiian Gardens, CA 90716 | 2007-03-07 |
| 1326102013 | Hyun Chan Lee | Dentist | 12137 E Carson St, Hawaiian Gardens, CA 90716 | 2006-12-20 |
| 1871656488 | Elena G Ezpeleta | Anesthesiology | 21530 South Pioneer Blvd, Hawaiian Gardens, CA 90716 | 2006-12-18 |
| 1144388687 | Jong Chul Han | Dentist | 11846 E Carson St, Hawaiian Gardens, CA 90716 | 2006-12-05 |
| 1912075235 | Chung Min Lee | Pediatrics | 12121 E Carsons St, Hawaiian Gardens, CA 90716 | 2006-12-04 |
| Find all providers in zip 90716 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083946180 | Platinum Medical Group | Specialist | 21520 Pioneer Blvd Ste 203, Hawaiian Gardens, CA 90716-2601 | 2010-02-01 |
| 1477726693 | Raymond Folmar M.d., Inc. | Specialist | 21508 Norwalk Blvd, Hawaiian Gardens, CA 90716-1122 | 2008-04-09 |
| 1417146317 | New Horizon Medical Corp. | Specialist | 21520 Pioneer Blvd, #202, Hawaiian Gardens, CA 90716-2603 | 2007-10-17 |
| 1184837908 | Nimish Shah | Specialist | 21520 Pioneer Blvd, #202, Hawaiian Gardens, CA 90716-2603 | 2007-05-08 |
| 1235282864 | Mathias A.l. Fobi | Specialist | 21520 Pioneer Blvd, Suite 204, Hawaiian Gardens, CA 90716-2603 | 2007-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113072 | Jonalyn Coronel | Specialist | 653 Canyon Rd, Novato, CA 94947-4331 | 2020-10-28 |
| 1497353239 | Nadia Nodoust-christensen | Specialist | 1627 Curtis Ave, Manhattan Beach, CA 90266-7022 | 2020-10-14 |
| 1073111936 | Griffin Nutrition Xterem | Specialist | 21575 Dome Trl, Topanga, CA 90290-3645 | 2020-10-13 |
| 1811503162 | George Thomas Lafortune | Specialist | 7927 Painter Ave Ste 200, Whittier, CA 90602-2480 | 2020-09-22 |
| 1699383661 | Transgender Health and Wellness Center | Specialist | 6700 Indiana Ave Ste 252, Riverside, CA 92506-4264 | 2020-07-16 |
| 1700403524 | Kelly Phillips | Specialist | 4650 Fruitvale Rd, Newcastle, CA 95658-9240 | 2020-06-27 |
| 1417572462 | Sarah Velez | Specialist | 1001 Potrero Ave Rm 7g19, San Francisco, CA 94110-3518 | 2020-06-15 |
| 1295350668 | Bette Graff | Specialist | 4148 10th St, Riverside, CA 92501-3110 | 2020-06-11 |
| 1114541463 | Serena Mink | Specialist | 100 Park Plz Apt 407, San Diego, CA 92101-6710 | 2020-06-02 |
| 1811510043 | Michael J Kodrich | Specialist | 40555 California Oaks Rd, Murrieta, CA 92562-5723 | 2020-05-21 |
| Find all providers with the same taxonomy | ||||
| City | HAWAIIAN GARDENS |
| Zip Code | 90716 |
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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.