NPIMap

Organization Active NPI

Adult & Child Neurology Medical Associates Inc.

  • Neurology Physician
  • Long Beach, CA
National Provider Identifier
1013959402
Registry record updated Jun 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G77927 Issued in CA
Legal business name
ADULT & CHILD NEUROLOGY MEDICAL ASSOCIATES INC.
Doing business as
adult & child neurology medical associates inc.
Practice address
2880 Atlantic Ave
260
Long Beach, CA 90806-1714
Phone
(562) 490-3580
Fax
(562) 490-3584
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Thanh T Le, M.D.NPI 1134165350
Title
Treasurer
Phone
(562) 490-3580

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X G77927 CA Primary

Addresses

Primary practice location

2880 Atlantic Ave
260
Long Beach, CA 90806-1714

Mailing address

2880 Atlantic Ave
260
Long Beach, CA 90806-1714
Phone (562) 490-3580

Other names 1

  • adult & child neurology medical associates inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071012000629 CA Part B Supplier - Clinic/Group Practice 1355437914 Receives reassigned benefits from 6 practitioners
Practice locations: Long Beach, CA

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1013959402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 ATLANTIC AVE",
            "address_2": "260",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061714",
            "telephone_number": "562-490-3580",
            "fax_number": "562-490-3584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 ATLANTIC AVE",
            "address_2": "260",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061714",
            "telephone_number": "562-490-3580",
            "fax_number": "562-490-3584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT & CHILD NEUROLOGY MEDICAL ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2015-06-10",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "THANH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "562-490-3580",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G77927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "adult & child neurology medical associates inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.