Access Alliance Medical Group, Inc
NPI 1629534045ActiveOrganization· Nurse Practitioner, Primary Care· Glendale, CA
Nurse Practitioner, Primary Care in Glendale, California, registered in NPPES in February 2019. The authorized official on file is Charlie A. Ponce, Chief Finance Officer. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1629534045 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 11, 2019 |
| Last updated in NPPES | Jun 26, 2025 |
| Certified by provider | Jun 26, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Primary Care Primary | 363LP2300X | — | — |
| Physician Assistant | 363A00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
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