Organization Active NPI

Pipeline Community Specialty Clinic

  • Family Medicine Physician
  • Gardena, CA
National Provider Identifier
1053082586
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PIPELINE COMMUNITY SPECIALTY CLINIC
Practice address
1141 W Redondo Beach Blvd Ste 212
Gardena, CA 90247-3584
Phone
(310) 698-5463
NPI assigned
Sep 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Authorized official

Name
Vincent Green, MD
Title
Authorized Official
Phone
(310) 321-0143

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1141 W Redondo Beach Blvd Ste 212
Gardena, CA 90247-3584

Mailing address

PO Box 80717
City of Industry, CA 91716-8416
Phone (310) 321-0143

Other practice location 1

4036 Whittier Blvd Ste 201
Los Angeles, CA 90023-2561
Phone (310) 698-5463

Other practice location 2

13132 Studebaker Rd Ste 7
Norwalk, CA 90650-2562
Phone (310) 698-5463

National Provider Directory

National Provider Directory

Locations

1141 W Redondo Beach Blvd
Ste 212
Gardena, CA 90247
Phone (310) 512-6141

Practitioners & affiliated clinicians

Practitioners 2

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": "1632355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1053082586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80717",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917168416",
            "telephone_number": "310-321-0143",
            "fax_number": "310-379-4856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 W REDONDO BEACH BLVD STE 212",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473584",
            "telephone_number": "310-698-5463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4036 Whittier Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900232561",
            "country_code": "US",
            "telephone_number": "310-698-5463",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13132 Studebaker Rd Ste 7",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CA",
            "postal_code": "906502562",
            "country_code": "US",
            "telephone_number": "310-698-5463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PIPELINE COMMUNITY SPECIALTY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-23",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "310-321-0143",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.