AMG- A PROFESSIONAL MEDICAL CORPORATION (NPI# 1306263645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306263645 |
| Entity Type | Organization |
| Organization Name | AMG- A PROFESSIONAL MEDICAL CORPORATION |
| Other Organization Name | AMG MEDICAL GROUP- PASADENA |
| Practice Address |
193 E Orange Grove Blvd Pasadena CA 91103-3487 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 6265683302 |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2014-03-25 |
| Authorized Official Name | KENNY HEINE (VP OF OPERATIONS) |
| Authorized Official Telephone | 8589641506 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 90656 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| AMG Medical Group- Pasadena | Doing Business As Name - Organization |
| Street Address |
193 E ORANGE GROVE BLVD |
| City | PASADENA |
| State | CA |
| Zip Code | 91103-3487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497790349 | Amg, A Professional Medical Corp | Pediatrics | 193 E Orange Grove Blvd, Pasadena, CA 91103-3487 | 2006-06-17 |
| 1558409276 | Cindy B Simkovich | Nurse Practitioner | 193 E Orange Grove Blvd, Pasadena, CA 91103-3487 | 2007-02-02 |
| 1205974979 | Catherine Theresa Meng | Nurse Practitioner | 193 E Orange Grove Blvd, Pasadena, CA 91103-3487 | 2007-02-02 |
| 1831113901 | Luong Trung Do | Pediatrics | 193 E Orange Grove Blvd, Pasadena, CA 91103-3487 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013407071 | Sean Patrick Comingore | Counselor | 1680 N. Fair Oaks Ave., Pasadena, CA 91103 | 2018-05-15 |
| 1093230252 | John Jesus Smith | Rehabilitation Practitioner | 867 Fair Oaks Ave, Pasadena, CA 91103 | 2017-08-09 |
| 1760906085 | Roberto Sotelo Jr. | Licensed Vocational Nurse | 867 North Fair Oaks Ave., Pasadena, CA 91103 | 2017-07-28 |
| 1477076172 | Towana Danielle Hooks | Rehabilitation Practitioner | 867 North Fair Oaks, Pasadena, CA 91103 | 2017-07-25 |
| 1437671807 | Yolanda Centeno | Marriage & Family Therapist | 867 Fairoaks., Pasadena, CA 91103 | 2017-07-07 |
| 1306366604 | Joseph Anthony Zepeda | Counselor | 1680 N. Fair Oaks Avenue, Pasadena, CA 91103 | 2017-06-27 |
| 1922537372 | Chaznii Bradford | Licensed Vocational Nurse | 867 N. Fair Oaks, Pasadena, CA 91103 | 2017-06-08 |
| 1629505425 | Wassim Ammary | Pharmacist | 1855 South Fair Oaks Ave, Pasadena, CA 91103 | 2017-05-11 |
| 1679005920 | Grace Caroline Seto | Marriage & Family Therapist | 236 W. Mountain St, Suite 202d, Pasadena, CA 91103 | 2017-03-28 |
| 1225575293 | Catherine Lynn Gray | Psychologist | 30 North Raymond Avenue, Suite 403, Pasadena, CA 91103 | 2017-01-27 |
| Find all providers in zip 91103 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689923153 | Harcart Health Holdings LLC | Non-Pharmacy Dispensing Site | 8125 Ritchie Hwy, Ste H, Pasadena, MD 21122-6925 | 2012-08-30 |
| 1609927185 | Chad E Sullivan | Non-Pharmacy Dispensing Site | 4104 Yellowstone Dr, Pasadena, TX 77504-3427 | 2007-01-13 |
| 1295819837 | Above (b2) | Non-Pharmacy Dispensing Site | 8125 H Ritchie Highway, Pasadena, MD 21122-6925 | 2006-10-24 |
| 1952741019 | Ms-hc, LLC | Non-Pharmacy Dispensing Site | 8028 Ritchie Hwy, Suite 207, Pasadena, MD 21122-1075 | 2013-07-03 |
| 1295092021 | South Lake Medical Center Inc | Non-Pharmacy Dispensing Site | 350 S Lake Ave, Ste 280, Pasadena, CA 91101-3530 | 2012-04-18 |
| 1770840605 | Welman T. Lim, Dpm, Inc | Non-Pharmacy Dispensing Site | 131 N El Molino Ave, Suite 230, Pasadena, CA 91101-1873 | 2012-04-17 |
| 1346488962 | Ronald Rigor Md Inc | Non-Pharmacy Dispensing Site | 675 S Arroyo Pkwy, Suite 100-b, Pasadena, CA 91105-3263 | 2009-02-04 |
| 1902948839 | Health Care Partners, Inc. | Non-Pharmacy Dispensing Site | 988 S Fair Oaks Ave, Pasadena, CA 91105-2626 | 2007-02-14 |
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| 1285268391 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 1337 S Lovers Ln Ste D, Visalia, CA 93292-5249 | 2020-02-27 |
| 1790327732 | Triumph Specialties LLC | Non-Pharmacy Dispensing Site | 11100 Sepulveda Blvd # 8-519, Mission Hills, CA 91345-1131 | 2019-10-10 |
| 1487210365 | Artius Dermatology Associates P.C. | Non-Pharmacy Dispensing Site | 325 Mall Dr Ste 111, Hanford, CA 93230-5950 | 2019-05-15 |
| 1376030080 | Jane F Kardashian Md Inc | Non-Pharmacy Dispensing Site | 6769 N Fresno, Fresno, CA 93710 | 2018-04-18 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1043719206 | Southern California Orthopedic Institute L.p | Non-Pharmacy Dispensing Site | 4100 Empire Dr Ste 120, Bakersfield, CA 93309-0408 | 2018-02-02 |
| 1174032353 | Golden Gate Urology, Inc. | Non-Pharmacy Dispensing Site | 139 Townsend St Ste 100, San Francisco, CA 94107-1946 | 2017-09-20 |
| 1215462080 | Mas Management Group, Inc. | Non-Pharmacy Dispensing Site | 28446 Constellation Rd, Valencia, CA 91355-5081 | 2017-04-28 |
| 1730624719 | St. John's Well Child and Family Center Inc | Non-Pharmacy Dispensing Site | 326 W 23rd St, Los Angeles, CA 90007-2612 | 2016-12-29 |
| Find all providers with the same taxonomy | ||||
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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.