Medardo Supnet M.D. Inc

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

A46203 Issued in CA

Legal business name

MEDARDO SUPNET M.D. INC

Practice address

3585 E Imperial Hwy
Lynwood, CA 90262-2654

Phone

(310) 605-4260

Fax

(310) 605-4263

NPI assigned

Apr 10, 2008

Organization subpart

No

Name

Meliza Dayrit

Title

Office Manager

Phone

(310) 605-4260

Organizations that report the same tax identification number in the National Provider Directory.

• Medardo C. Supnet, M.D., Inc

  • Specialist
  • Norwalk, CA
  • NPI 1417069303
  NPD tax ID
• Medardo C. Supnet, M.D., Inc

  • Specialist
  • Lynwood, CA
  • NPI 1699923235
  NPD tax ID

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrew I Florentino, M.D.

  • Pediatrics Physician
  • Lynwood, CA
  • NPI 1780796763
  NPD (past)
• Arjie Alea Florentino

  • Medical Physician Assistant
  • Lynwood, CA
  • NPI 1508519661
  NPD (past)
• Medardo C. Supnet, M.D.

  • Pediatrics Physician
  • Lynwood, CA
  • NPI 1992817860
  NPD (past)

Tax ID family

Medardo C Supnet MD Inc (3 organizations share this tax ID)

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 10, 2008.

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1003089970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3585 E IMPERIAL HWY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622654",
            "telephone_number": "310-605-4260",
            "fax_number": "310-605-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3585 E IMPERIAL HWY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622654",
            "telephone_number": "310-605-4260",
            "fax_number": "310-605-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDARDO SUPNET M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "DAYRIT",
        "authorized_official_first_name": "MELIZA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "310-605-4260"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "CA",
            "license": "A46203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417069303",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alize McNair-Braggs
• Erika McNeal, NP
• Med Forte Medical Group
• Med-Pro Famliy Clinic
• Medardo C. Supnet, M.D., Inc
• Medicera Inc.
• Jennifer Medina, LCSW
• Sara Medina
• Susana Medina
• Eric Medrano

• All providers in Lynwood, CA
• Legal Medicine in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.