BIOGENX MEDICAL (NPI# 1962912246) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962912246 |
| Entity Type | Organization |
| Organization Name | BIOGENX MEDICAL |
| Other Organization Name | BIOGENX MEDICAL |
| Practice Address |
620 S Glendora Ave Ste B Glendora CA 91740-6815 |
| Practice Telephone | 8188362475 |
| Practice Fax Number | 3109431475 |
| Mailing Telephone | 8188362475 |
| Mailing Fax Number | 3109431475 |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2018-03-02 |
| Authorized Official Name | DR. CHRISTOPHER A OTIKO (MANAGER) |
| Authorized Official Telephone | 8188362475 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
G77666 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CALIFORNIA MEDICAL LICENSE | G77666 | 01 |
| Other Name | Type Code |
|---|---|
| Biogenx Medical | Doing Business As Name - Organization |
| Coast to Coast Medical | Doing Business As Name - Organization |
| Street Address |
620 S GLENDORA AVE STE B |
| City | GLENDORA |
| State | CA |
| Zip Code | 91740-6815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740729805 | Esther Wanja Wachira | Nurse Practitioner | 620 S Glendora Ave Ste B, Glendora, CA 91740-6815 | 2017-02-21 |
| 1568992493 | Coast To Coast Medical Inc | Internal Medicine | 620 S Glendora Ave Ste B, Glendora, CA 91740-6815 | 2017-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215559638 | Kenny Tokuji Michioka | Nurse Practitioner | 1208 S Barranca Ave Unit C, Glendora, CA 91740 | 2020-05-07 |
| 1629535380 | Sudario Home Health Care, Inc. | Home Health | 620 W Riute 66 Suite 220a, Glendora, CA 91740 | 2019-02-28 |
| 1659872711 | Matthew Christian Mendoza | Counselor | 1160 S Grand Avenue, Glendora, CA 91740 | 2018-02-23 |
| 1972029981 | Keyauna C Thomas | Case Manager/Care Coordinator | 987 Shady Lane, Glendora, CA 91740 | 2017-08-21 |
| 1356891055 | Stephanie L Contreras | Counselor | 2200 E Route 66 Ste 200, Glendora, CA 91740 | 2016-10-06 |
| 1912454547 | Natalie Sayegh | Dentist | 102 W. Route 66, Suite G, Glendora, CA 91740 | 2016-09-01 |
| 1255715744 | Daily Care,llc | Non-emergency Medical Transport (VAN) | 623 Lemar Park Drive, B, Glendora, CA 91740 | 2015-07-14 |
| 1245661776 | Rjdj Hospice Care, Inc. | Hospice Care, Community Based | 631 E. Arrow Hwy Ste E, Glendora, CA 91740 | 2013-12-10 |
| 1285061168 | Nam Dao | Nurse Practitioner | 1377 S. Grand Ave, Glendora, CA 91740 | 2013-10-09 |
| 1508292384 | Keaunna Sonae Knox | Speech-Language Pathologist | 420 E. Baseline St Suite D & E, Glendora, CA 91740 | 2013-09-24 |
| Find all providers in zip 91740 | ||||
| Taxonomy Code | 2083P0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Preventive Medicine/Occupational Environmental Medicine |
| A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750911665 | Healthstat Wellness Sutter County | Preventive Medicine | 1215 Plumas St Ste 1300a, Yuba City, CA 95991-3400 | 2020-01-20 |
| 1194373530 | Healthstat Wellness County of Santa Barbara Headquarters | Preventive Medicine | 427 Camino Del Remedio Bldg G, Santa Barbara, CA 93110-1310 | 2019-08-29 |
| 1023678661 | Linda K Watanabe | Preventive Medicine | 700 Bay Rd. #2803, Redwood City, CA 94063 | 2019-06-17 |
| 1750872255 | Universal Occupational Medicine PC | Preventive Medicine | 8303 Brimhall Rd Bldg 1500, Bakersfield, CA 93312-2243 | 2018-05-21 |
| 1831694272 | Healthstat Wellness County Sb Headquarters | Preventive Medicine | 2500 Broadway Ste 400, Santa Monica, CA 90404-3176 | 2018-03-28 |
| 1326548363 | Paul Manchester | Preventive Medicine | 11159 Corte Pleno Verano, San Diego, CA 92130-2688 | 2018-02-16 |
| 1295240679 | Robert A Brooks | Preventive Medicine | 149 South Barrington Ave, #346, Los Angeles, CA 90049 | 2017-12-07 |
| 1285145383 | Brett V. Curtis M.d. & Associates, A Professional Corporation | Preventive Medicine | 7428 Redwood Blvd Ste 100, Novato, CA 94945-2418 | 2017-10-16 |
| 1104355783 | Susan Bradshaw | Preventive Medicine | 6320 W Howard Drollinger Way Ste 203, Los Angeles, CA 90045-3627 | 2017-06-07 |
| 1386097806 | Healthstat Wellness Bac Madera | Preventive Medicine | 15341 Road 28 1/2, Madera, CA 93638-2325 | 2016-07-20 |
| 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.