Individual provider Active NPI

Tina Der Kitajima, M.D.

  • Internal Medicine Physician
  • Long Beach, CA
National Provider Identifier
1033164892
Registry record updated Mar 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A068088 Issued in CA
Practice address
2699 Atlantic Ave
Long Beach, CA 90806-2710
Phone
(562) 426-3333
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A068088 CA Primary

Addresses

Primary practice location

2699 Atlantic Ave
Long Beach, CA 90806-2710

Mailing address

2699 Atlantic Ave
Long Beach, CA 90806-2710
Phone (562) 426-3333

Other names 1

  • Tina Der Former name

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
I20040116000827 CA Practitioner - Internal Medicine 3476454927 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A068088CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Internal Medicine Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Sep 1, 2008 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Sep 1, 2008 Accepting new patients
Memorial Medical Group Inc Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

440 E Huntington Dr
Arcadia, CA 91006
Phone (626) 254-2293

450 E Huntington Dr
Arcadia, CA 91006
Phone (626) 254-2100

300 W Huntington Dr
Arcadia, CA 91007
Phone (626) 445-4441

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

818 W Alondra Blvd
Compton, CA 90220
Phone (310) 537-1137

500 Alamitos Ave
Long Beach, CA 90802
Phone (310) 432-5661

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

2699 Atlantic Ave
Long Beach, CA 90806
Phone (562) 426-2105

2925 Palo Verde Ave
Long Beach, CA 90815
Phone (562) 421-2757

675 S Arroyo Pkwy
Pasadena, CA 91105
Phone (626) 585-4120

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238371200000",
    "number": "1033164892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2699 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062710",
            "telephone_number": "562-426-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2699 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062710",
            "telephone_number": "562-426-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITAJIMA",
        "first_name": "TINA",
        "middle_name": "DER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2009-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A068088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "DER",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.