Active NPI
Multicare Medical Center Corp
- Internal Medicine Physician
- San Pedro, CA
National Provider Identifier
1043679368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- MULTICARE MEDICAL CENTER CORP
- Practice address
- 505 S Pacific Ave
Suite #201
San Pedro, CA 90731-2656 - Phone
- (424) 570-6960
- Fax
- (424) 570-6952
- NPI assigned
- Feb 15, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bao T Nguyen, M.D.
- Title
- President
- Phone
- (424) 570-6960
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary | ||
| Pain Medicine Physician | 208VP0000X |
Addresses
Primary practice location
505 S Pacific Ave
Suite #201
San Pedro, CA 90731-2656
Mailing address
PO Box 3129
Torrance, CA 90510-3129
Phone (310) 792-3914
Other names 1
- MULTICARE MEDICAL CENTER
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455494400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1455753600000",
"number": "1043679368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3129",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905103129",
"telephone_number": "310-792-3914",
"fax_number": "855-898-4055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 S PACIFIC AVE",
"address_2": "SUITE #201",
"city": "SAN PEDRO",
"state": "CA",
"postal_code": "907312656",
"telephone_number": "424-570-6960",
"fax_number": "424-570-6952"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MULTICARE MEDICAL CENTER CORP",
"organizational_subpart": "NO",
"enumeration_date": "2016-02-15",
"last_updated": "2016-02-18",
"status": "A",
"authorized_official_last_name": "NGUYEN",
"authorized_official_first_name": "BAO",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "424-570-6960",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "208VP0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pain Medicine, Pain Medicine",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "MULTICARE MEDICAL CENTER",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in San Pedro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.