JAGA MEDICAL GROUP INC NPI 1356898357

NPI Information

NPI: 1356898357
Provider Name: JAGA MEDICAL GROUP INC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
1400 COLORADO BLVD
A
EAGLE ROCK, CA
ZIP 90041
Phone: (323) 999-2250
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JAGA MEDICAL GROUP INC is a general practice in Eagle Rock, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee JAGA MEDICAL GROUP INC NPI is 1356898357. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1400 COLORADO BLVD
A
EAGLE ROCK, CA
ZIP 90041-321
Phone: (323) 999-2250
Fax: (323) 999-2241

The provider's authorized official is Ardienne Ann Grant .
The authorized official title is President and has the following contact phone number (323) 999-2250.

The enumeration date for this NPI number is 9/7/2016 and was last updated on 10/20/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		20A7285	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	20A7285	MEDICARE OSCAR/CERTIFICATION	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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