MESA ADVANTAGE MEDICAL GROUP NPI 1578017778

Exclusive Provider Organization in San Marino, CA

NPI 1578017778 Organization Exclusive Provider Organization

About MESA ADVANTAGE MEDICAL GROUP

Mesa Advantage Medical Group is a provider established in San Marino, California specializing in exclusive provider organization. The NPI number of Mesa Advantage Medical Group is 1578017778 and was assigned on August 2016. The practitioner's primary taxonomy code is 302F00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Ms. Lan Nhu Bich Phan (Ceo)

NPI

1578017778

Provider NameMESA ADVANTAGE MEDICAL GROUP
Provider Location Address2295 HUNTINGTON DR # D SAN MARINO, CA 91108
Provider Mailing Address2295 HUNTINGTON DR # D SAN MARINO, CA 91108
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date08-05-2016
Last Update Date08-05-2016


Primary Taxonomy

Taxonomy Code302F00000X
ClassificationExclusive Provider Organization
TypeManaged Care Organizations
Taxonomy Description(1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations.

Business Address

MESA ADVANTAGE MEDICAL GROUP
2295 HUNTINGTON DR # D
SAN MARINO, CA
ZIP 91108
Phone: (626) 656-2370
Fax: (626) 248-9060

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Mailing Address

MESA ADVANTAGE MEDICAL GROUP
2295 HUNTINGTON DR # D
SAN MARINO, CA
ZIP 91108
Phone: (626) 656-2370
Fax: (626) 248-9060



Authorized Official

Authorized Official NameMS. LAN NHU BICH PHAN
Authorized Official TitleCEO
Authorized Official Phone(818) 399-8996

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1302F00000XManaged Care OrganizationsExclusive Provider OrganizationA=========CANo

Taxonomy Description: (1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations.

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1124441696IMPERIAL HEALTH HOLDINGS, A PROFESSIONAL MEDICAL CORPORATION
Organization
Exclusive Provider Organization2295 HUNTINGTON DR # D
SAN MARINO, CA 91108
(626) 656-2370

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.