Organization Active NPI

Montes Medical Group Inc

  • Family Medicine Physician
  • Inglewood, CA
National Provider Identifier
1093809592
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MONTES MEDICAL GROUP INC
Practice address
832 S. Grevillea Ave.
Inglewood, CA 90301-3312
Phone
(310) 419-4354
Fax
(310) 419-4621
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Authorized official

Name
Dr. Juan Zepeda Montes, M.D.
Title
Medical Director
Phone
(310) 419-4354

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

832 S. Grevillea Ave.
Inglewood, CA 90301-3312

Mailing address

832 S. Grevillea Ave.
Inglewood, CA 90301-3312
Phone (310) 419-4354

Other identifiers 1

IdentifierTypeStateIssuer
GR0026811MedicaidCA

Other names 1

  • MONTES MEDICAL GROUP INC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100618000315 CA Part B Supplier - Clinic/Group Practice 6002946001 Receives reassigned benefits from 22 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Los Angeles, CA; Whittier, CA; Norwalk, CA; Inglewood, CA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0881927Montes Medical Group Inc832 S Grevillea Ave, Inglewood, CA 90301Certificate of waiverJan 24, 2028

National Provider Directory

National Provider Directory

Locations

4545 E 3rd St
Los Angeles, CA 90022
Phone (323) 261-3098

13820 San Antonio Dr
Norwalk, CA 90650
Phone (562) 317-1532

13345 Telegraph Rd
Whittier, CA 90605

13345 Telegraph Rd
Ste G
Whittier, CA 90605

11822 Floral Dr
Ste A
Whittier, CA 90601

Practitioners & affiliated clinicians

Practitioners 10

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711670400000",
    "number": "1093809592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 S. GREVILLEA AVE.",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903013312",
            "telephone_number": "310-419-4354",
            "fax_number": "310-419-4621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 S. GREVILLEA AVE.",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903013312",
            "telephone_number": "310-419-4354",
            "fax_number": "310-419-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTES MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A",
        "authorized_official_last_name": "MONTES",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "ZEPEDA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-419-4354",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0026811",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MONTES MEDICAL GROUP INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.