PATHWAY MEDICAL GROUP, INC (NPI# 1407802069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407802069 |
| Entity Type | Organization |
| Organization Name | PATHWAY MEDICAL GROUP, INC |
| Practice Address |
12462 Brookhurst St #a&b Garden Grove CA 92840-4759 |
| Mailing Address |
Po Box 2989 Seal Beach CA 90740-1989 |
| Practice Telephone | 7146369850 |
| Practice Fax Number | 7146361248 |
| Mailing Telephone | 7146369850 |
| Mailing Fax Number | 7146361248 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2008-05-06 |
| Authorized Official Name | DR. HASSAN M. ALKHOULI (C.E.O.) |
| Authorized Official Telephone | 7143793221 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | PATHWAY MEDICAL GROUP, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0100561 | 05 | |
| CA | GR0100560 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164473757 | Pathway Medical Group, Inc | Internal Medicine | 7955 Westminster Blvd, Westminster, CA 92683-4001 | 2006-05-16 |
| 1902853302 | Pathway Medical Group, Inc | Physician Assistant | 12555 Garden Grove Blvd, #507, Garden Grove, CA 92843-1902 | 2006-05-30 |
| 1578519054 | Pathway Medical Group, Inc | Nurse Practitioner | 11100 Warner Ave, #120, Fountain Valley, CA 92708-7506 | 2006-05-26 |
| 1184670762 | Pathway Medical Group, Inc | Internal Medicine | 12665 Garden Grove Blvd, #502-a, Garden Grove, CA 92843-1901 | 2006-05-26 |
| Street Address |
12462 BROOKHURST ST #A&B |
| City | GARDEN GROVE |
| State | CA |
| Zip Code | 92840-4759 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497076301 | Negin Behazin | Internal Medicine | 12462 Brookhurst St, Garden Grove, CA 92840-4759 | 2010-06-15 |
| 1821270273 | Dena Marie Fisher | Physician Assistant | 12462 Brookhurst St, Suite A&b, Garden Grove, CA 92840-4759 | 2007-11-28 |
| 1497790661 | Paul G Johnson | Family Medicine | 12462 Brookhurst St, #a&b, Garden Grove, CA 92840-4759 | 2006-06-19 |
| 1518902782 | Pam Maurer | Physician Assistant | 12462 Brookhurst St, #a&b, Garden Grove, CA 92840-4759 | 2006-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588283808 | Kimberly Gaeta | Behavioral Analyst | 123935 Lewis Street, Ste 202, Garden Grove, CA 92840 | 2020-04-16 |
| 1396397170 | Rosa Cortez | Behavior Technician | 12443 Lewis Street, #201, Garden Grove, CA 92840 | 2019-07-12 |
| 1376005934 | Sekboppa Sor | Nurse Practitioner | An Lanh Free Clinic, 10861 Acacia Pkwy., Garden Grove, CA 92840 | 2019-04-03 |
| 1346730116 | Vinh Le Tran | Pharmacist | 12666 Brookhurst St. Suite 110, Garden Grove, CA 92840 | 2018-05-16 |
| 1841715232 | Scott R. Blair | Physician Assistant | 12828 Harbor Blvd Ste 200, Garden Grove, CA 92840 | 2017-08-07 |
| 1881049492 | Carmen Keally | Dietitian, Registered | 12602 9th St, Garden Grove, CA 92840 | 2016-05-02 |
| 1548688732 | House Call Medical Associates, Inc. | Internal Medicine | 12865 Main St Ste 105, Garden Grove, CA 92840 | 2014-04-03 |
| 1851733059 | Carly Ann Wade | Marriage & Family Therapist | 12755 Brookhurst St. Ste 116, Garden Grove, CA 92840 | 2013-07-29 |
| 1003159864 | Priyal Shah Ohri | Dentist | 10602 Chapman Ave, Suite 200, Garden Grove, CA 92840 | 2013-03-30 |
| 1770853244 | Joseph Pham | Pharmacist | 12001 Euclid St., Garden Grove, CA 92840 | 2011-12-30 |
| Find all providers in zip 92840 | ||||
| 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 |
|---|---|---|---|---|
| 1104470301 | Khoi Dinh Nguyen Medical Office Inc | Family Medicine | 12372 Garden Grove Blvd Ste B, Garden Grove, CA 92843-1804 | 2019-07-26 |
| 1003336041 | Aaa Medical Group | Family Medicine | 13071 Brookhurst St Ste 110, Garden Grove, CA 92843-1047 | 2017-06-21 |
| 1437513892 | Essential Care Medical | Family Medicine | 10741 Westminster Ave Ste 101, Garden Grove, CA 92843-3397 | 2016-04-11 |
| 1841534633 | Nhu Van Truong Md A Medical Corporation | Family Medicine | 10402 Westminster Ave, #100b, Garden Grove, CA 92843-4862 | 2012-11-16 |
| 1508155102 | Adoc Acquisition Co., A Medical Group, Inc. | Family Medicine | 12966 Euclid St Ste 340, Garden Grove, CA 92840-9205 | 2011-04-04 |
| 1336460914 | Timothy Thien Tran | Family Medicine | 12302 Garden Grove Blvd Ste 7, Garden Grove, CA 92843-1833 | 2010-06-17 |
| 1225282304 | Tram Anh Ngo | Family Medicine | 12100 Euclid St., Garden Grove, CA 92640 | 2008-11-16 |
| 1265682306 | Khiem D Lai Md Inc | Family Medicine | 12502 Brookhurst Street, Garden Grove, CA 92840-4807 | 2008-09-25 |
| 1104084771 | Janak R Chopra | Family Medicine | 12555 Garden Grove Blvd Ste 404, Garden Grove, CA 92843-1903 | 2008-05-29 |
| 1619160207 | Maryann Mona Walthier | Family Medicine | 6292 Amy Ave, Garden Grove, CA 92845-1808 | 2007-08-27 |
| Find all providers in GARDEN GROVE | ||||
| City | GARDEN GROVE |
| Zip Code | 92840 |
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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.