MGB MEDICAL GROUP, INC. – NPI #1720554041
Family Medicine

The NUCC recommends this code not be used. Choose a more appropriate code.

MGB MEDICAL GROUP, INC. is a provider located in NORTH HOLLYWOOD, CA. NPPES has assigned the NPI number 1720554041 to MGB MEDICAL GROUP, INC. on October 15, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207QA0505X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Adult Medicine

The NPI profile was previously updated about 7 years ago on Jan 25, 2019. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MGB MEDICAL GROUP, INC. below.

NPI Profile for
MGB MEDICAL GROUP, INC.

NPI Number
1720554041
Enumeration Date

(more than 7 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MGB MEDICAL GROUP, INC.
Primary location
7535 LAUREL CANYON BLVD
NORTH HOLLYWOOD, CA 91605-3149
Phone: (818) 962-5505 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
MICHAEL REPIK
PRESIDENT
Phone: (818) 962-5505
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207QA0505X
- Family Medicine / Adult Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.