PRIMA VIDA MEDICAL CLINIC, INC. (NPI# 1407143464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407143464 |
| Entity Type | Organization |
| Organization Name | PRIMA VIDA MEDICAL CLINIC, INC. |
| Practice Address |
8706 Imperial Hwy Downey CA 90242-3906 |
| Practice Telephone | 5629238300 |
| Mailing Telephone | 5629238300 |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2013-01-02 |
| Authorized Official Name | DR. ELEANOR VERZOSA AZURIN (PRESIDENT) |
| Authorized Official Telephone | 5629238300 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
A66742 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1407143464 | 05 |
| Street Address |
8706 IMPERIAL HWY |
| City | DOWNEY |
| State | CA |
| Zip Code | 90242-3906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760653885 | Carol Veneracion-godoy | Physician Assistant | 8706 Imperial Hwy, Downey, CA 90242-3906 | 2008-03-17 |
| 1457762155 | Prohealth Partners A Medical Group Inc | Physician Assistant | 8706 Imperial Hwy, Downey, CA 90242 | 2014-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972117182 | Andy Vo Osborne | Respiratory Therapist, Registered | 9333 E Imperial High Way, Downey, CA 90242 | 2020-09-04 |
| 1639783459 | Enrique Robles Soto | Behavior Technician | 12432 Bellflower Blvd., Downey, CA 90242 | 2020-08-31 |
| 1043842461 | Paul Yokoyama | Pharmacist | 9542 Dalen Street, Downey, CA 90242 | 2020-02-05 |
| 1639727837 | Demontay Deon High | Behavior Technician | 12342 Bellflower Blvd, Downey, CA 90242 | 2019-08-30 |
| 1467922328 | Nurisha Ficklin | Behavior Technician | 12342 Bellflower Blvd., Downey, CA 90242 | 2018-12-04 |
| 1235622358 | Marlene Castaneda | Occupational Therapist | 12555 Lakewood Blvd Ste D, Downey, CA 90242 | 2018-06-13 |
| 1942727383 | Arhtur Lozano | Non-emergency Medical Transport (VAN) | 13109 Woodruff Ave, Downey, CA 90242 | 2017-08-26 |
| 1336665983 | Laura E Del Val | Nurse Practitioner | 12207 Rives Ave, Downey, CA 90242 | 2017-08-16 |
| 1982127288 | Tiffany Chiyeko Yonemoto | Recreation Therapist | 7601 E. Imperial Hwy., Downey, CA 90242 | 2017-07-19 |
| 1265955504 | Julie Helgren | Recreation Therapist | 7601 E. Imperial Highway, Jpi Building Rm 1124, Downey, CA 90242 | 2017-07-19 |
| Find all providers in zip 90242 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1619232808 | Marilou G Cruz Md Inc | Clinic/Center | 8535 Florence Ave Ste 201, Downey, CA 90240-4014 | 2012-07-12 |
| 1174885909 | Clinica Medica Mi Pueblo, Medical Clinic Inc | Clinic/Center | 9360 Telegraph Rd, Downey, CA 90240-2425 | 2012-06-07 |
| 1598089054 | Domingo C Barrientos Medical Clinic Inc. | Clinic/Center | 10800 Paramount Blvd, Suite 203, Downey, CA 90241-3331 | 2010-03-25 |
| 1962433409 | Jamie C. Oey M.d., Inc | Clinic/Center | 10800 Paramount Blvd, Suite 302, Downey, CA 90241-3331 | 2006-07-05 |
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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.