{"npi":"1396260063","type":"NPI-2","status":"active","name":{"display":"Ultimate Health Medical Services Llc., A California Liability Company","other":[],"organization_name":"ULTIMATE HEALTH MEDICAL SERVICES LLC., A CALIFORNIA LIABILITY COMPANY","authorised_official":"Bertha Rosas"},"specialty":{"primary_taxonomy":"207RI0001X","primary_taxonomy_description":"Clinical & Laboratory Immunology (Internal Medicine) Physician","slug":"clinical-laboratory-immunology-internal-medicine-physician","schema_org_specialty":null,"all":[{"code":"207RI0001X","description":"Clinical & Laboratory Immunology (Internal Medicine) Physician","primary":true,"state":"CA","license":"A60718"}]},"addresses":[{"purpose":"LOCATION","street_1":"2800 PACIFIC AVE STE D","city":"LONG BEACH","state":"CA","postal_code":"908061468","country_code":"US","phone":"5623378401","fax":"5623378404"},{"purpose":"MAILING","street_1":"2800 PACIFIC AVE STE D","city":"LONG BEACH","state":"CA","postal_code":"908061468","country_code":"US","phone":"5623378401","fax":"5623378404"}],"license":{"state":"CA","number":"A60718"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"193200000X","state":"CA","issuer":null}],"pecos":{"enrolled_at":"2026-07-01T15:01:53.235063+00:00","enrollments":[{"enrlmt_id":"O20210614002231","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"CA","pac_id":"0143637041"}]},"enumeration_date":"2017-08-03","last_updated":"2022-07-21","_meta":{"source":"NPPES","snapshot_date":"2022-07-21","doc_url":"https://findmynpi.com/api"}}