Individual provider Active NPI

Jonathan Neal, D.O

  • Family Medicine Physician
  • Torrance, CA
National Provider Identifier
1073628434
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A8034 Issued in CA
Practice address
2382 Crenshaw Blvd Ste 5
Torrance, CA 90501-3333
Phone
(310) 618-9200
Fax
(310) 618-1241
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A8034 CA Primary

Addresses

Primary practice location

2382 Crenshaw Blvd Ste 5
Torrance, CA 90501-3333

Mailing address

2382 Crenshaw Blvd Ste 5
Torrance, CA 90501-3333
Phone (310) 618-9200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jneal196695@oc.providencedirect.org

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
I20040318001839 CA Practitioner - Family PracticePractitioner - Emergency Medicine 1658261953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

2382 Crenshaw Blvd
Suite 5
Torrance, CA 90501-3333
Phone (310) 618-9200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A8034CAMDFamily Medicine Physician
8034CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute Family Medicine CurrentSince May 14, 2019 Accepting new patients
Providence Medical Institute Family Medicine CurrentSince May 14, 2019 Accepting new patients
Providence Health System Southern California Past Accepting new patients

Locations

21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627

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

4314 W Slauson Ave
Los Angeles, CA 90043
Phone (323) 293-7171

1010 N Sepulveda Blvd
Manhattan Beach, CA 90266
Phone (310) 322-9700

3524 Torrance Blvd
Ste 100
Torrance, CA 90503
Phone (310) 316-2055

2382 Crenshaw Blvd
Ste 5
Torrance, CA 90501
Phone (310) 618-6200

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.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1073628434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2382 CRENSHAW BLVD STE 5",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905013333",
            "telephone_number": "310-618-9200",
            "fax_number": "310-618-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2382 CRENSHAW BLVD STE 5",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905013333",
            "telephone_number": "310-618-9200",
            "fax_number": "310-618-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "JONATHAN",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jneal196695@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2382 Crenshaw Blvd Ste 5",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905013333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.