Organization Active NPI

Multicare Medical Center Corp

  • Internal Medicine Physician
  • San Pedro, CA
National Provider Identifier
1043679368
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
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

Updated by the provider on Feb 18, 2016

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)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 Doing business as

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.