Individual provider Active NPI

Hayward Lynn Eubanks, M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Hawthorne, CA
National Provider Identifier
1023039815
Registry record updated Oct 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
G54388 Issued in CA
Practice address
4477 W 118TH St Ste 205
Hawthorne, CA 90250-2257
Phone
(310) 679-0676
Fax
(310) 679-0087
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X G54388 CA Primary

Addresses

Primary practice location

4477 W 118TH St Ste 205
Hawthorne, CA 90250-2257

Mailing address

4477 W 118TH St
Suite# 205
Hawthorne, CA 90250-2255
Phone (310) 679-0676

Other practice location 1

5529 Secrest Dr
Los Angeles, CA 90043-2029
Phone (323) 296-3431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070111000130 CA Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 5890795108 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
University of California, Geffen School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4477 W 118TH St
Suite 205
Hawthorne, CA 90250-2257
Phone (310) 679-0676

Hospital & facility affiliations

  • California Hospital Medical Center la Hospital, Los Angeles, CA, CCN 050149
  • Kindred Hospital South Bay Long-term care hospital, Gardena, CA, CCN 052050
  • Kindred Hospital - Los Angeles Long-term care hospital, Los Angeles, CA, CCN 052032

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G54388CAMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hayward L Eubanks M D a Medical Corporation Otolaryngology/Facial Plastic Surgery CurrentSince Apr 20, 2019 Accepting new patients
County of Los Angeles CurrentSince Mar 18, 2013 Accepting new patients
County of Los Angeles CurrentSince Mar 18, 2013 Accepting new patients

Locations

1000 S Fremont Ave
Bldg A11
Alhambra, CA 91803
Phone (626) 457-4240

7601 Imperial Hwy
Downey, CA 90242
Phone (310) 940-8111

4477 W 118th St
Ste 205
Hawthorne, CA 90250
Phone (310) 679-0676

1670 E 120th St
Los Angeles, CA 90059
Phone (424) 338-1000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728777600000",
    "number": "1023039815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4477 W 118TH ST",
            "address_2": "SUITE# 205",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902502255",
            "telephone_number": "310-679-0676",
            "fax_number": "310-679-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4477 W 118TH ST STE 205",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902502257",
            "telephone_number": "310-679-0676",
            "fax_number": "310-679-0087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5529 Secrest Dr",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900432029",
            "country_code": "US",
            "telephone_number": "323-296-3431",
            "fax_number": "310-679-0087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EUBANKS",
        "first_name": "HAYWARD",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2024-10-13",
        "certification_date": "2024-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "CA",
            "license": "G54388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.