Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Great Spirit Medical Group, Inc

Organization Family Medicine Physician · NPI 1407869928

Great Spirit Medical Group, Inc is a Family Medicine Physician in Northridge, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

9900 Balboa Blvd Ste A
Northridge, CA 91325-5403
Phone: (818) 701-0017
Fax: (818) 701-0073
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A48817 (CA)

Record details

NPI number1407869928
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Conrado Miranda — Medical Director · (818) 701-0017
NPI enumeratedAugust 14, 2006
Last updated in NPPESNovember 12, 2007
Mailing address9900 Balboa Blvd, Suite A, Northridge, CA 91325-5403

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