Individual provider Active NPI

Dwight Wayne Malone, M.D.

  • Family Medicine Physician
  • Torrance, CA
National Provider Identifier
1093886269
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G71749 Issued in CA
Practice address
4201 Torrance Blvd
Ste 790
Torrance, CA 90503-4561
Phone
(323) 779-2800
Fax
(323) 754-4014
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 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 G71749 CA Primary

Addresses

Primary practice location

4201 Torrance Blvd
Ste 790
Torrance, CA 90503-4561

Mailing address

4201 Torrance Blvd
Ste 790
Torrance, CA 90503-4561
Phone (323) 779-2800

Other identifiers 1

IdentifierTypeStateIssuer
OOG717490MedicaidCA

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
I20081210000590 CA Practitioner - Family Practice 5092876961 Practice locations: Carson, CA; Torrance, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Meharry Medical College School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4201 Torrance Blvd
Suite 790
Torrance, CA 90503-4561
Phone (310) 649-4800

940 E Dominguez St
Suite G
Carson, CA 90746-7202
Phone (310) 778-0180

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71749CAMDMarriage & Family Therapist
G71749CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Medical Group Inc Family Medicine Current Accepting new patients
Cedars-Sinai Marina Hospital Past Accepting new patients
Deorosan Professional Medical Corporation PastSince Jun 30, 2008 Accepting new patients
Howard Fein MD Inc Past Accepting new patients

Locations

5230 Pacific Concourse Dr
Ste 110
Los Angeles, CA 90045
Phone (310) 643-0821

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1093886269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 TORRANCE BLVD",
            "address_2": "STE 790",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034561",
            "telephone_number": "323-779-2800",
            "fax_number": "323-754-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 TORRANCE BLVD",
            "address_2": "STE 790",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034561",
            "telephone_number": "323-779-2800",
            "fax_number": "323-754-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "DWIGHT",
        "middle_name": "WAYNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G71749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OOG717490",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.