Active NPI
Clement Jerry Kovar II, M.D.
- Anesthesiology Physician
- Torrance, CA
National Provider Identifier
1104848399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G25022
- Practice address
- 3330 Lomita Blvd
Torrance, CA 90505-5002 - Phone
- (310) 325-9110
- Fax
- (310) 784-8762
- NPI assigned
- Jul 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G25022 | CA | Primary |
Addresses
Primary practice location
3330 Lomita Blvd
Torrance, CA 90505-5002
Mailing address
PO Box 60790
Pasadena, CA 91116-6790
Phone (626) 795-6596
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G250220 | Other | CA | BLUE SHIELD |
| 00G250220 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Torrance Memorial Medical Center | Past | Accepting new patients | |
| Torrance Anesthesia Medical Group Inc. | Anesthesiology | Past | Accepting new patients |
| Providence Health System Southern California | Past | Accepting new patients |
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.
-
dba Providence Little Company of Mary Medical Center Torrance
- General Acute Care Hospital
- Torrance, CA
- NPI 1902844988
-
- Anesthesiology Physician
- Torrance, CA
- NPI 1902824642
-
- Skilled Nursing Facility
- Torrance, CA
- NPI 1740268713
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296691200000",
"number": "1104848399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60790",
"city": "PASADENA",
"state": "CA",
"postal_code": "911166790",
"telephone_number": "626-795-6596",
"fax_number": "626-396-0851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3330 LOMITA BLVD",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905055002",
"telephone_number": "310-325-9110",
"fax_number": "310-784-8762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOVAR",
"first_name": "CLEMENT",
"middle_name": "JERRY",
"name_suffix": "II",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2011-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G25022",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00G250220",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G250220",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Torrance, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.