Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Great Spirit Medical Group, Inc

Organization Family Medicine Physician · NPI 1407869928

Great Spirit Medical Group, Inc provides Family Medicine Physician services 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 Not confirmed with CMS for 18 years — call before visiting
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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