NPIMap

Organization Active NPI

M.D. Medical Center, Inc

  • Family Medicine Physician
  • Monterey Park, CA
National Provider Identifier
1124051578
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G62452 Issued in CA
Legal business name
M.D. MEDICAL CENTER, INC
Practice address
600 N Garfield Ave
Suite 111
Monterey Park, CA 91754-1166
Phone
(626) 280-3651
Fax
(626) 280-3079
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Authorized official

Name
Dr. Terry M Lee, M.D.NPI 1184796104
Title
President
Phone
(626) 280-3651

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X G62452 CA Primary

Addresses

Primary practice location

600 N Garfield Ave
Suite 111
Monterey Park, CA 91754-1166

Mailing address

600 N Garfield Ave
Suite 111
Monterey Park, CA 91754-1166
Phone (626) 280-3651

Other identifiers 1

IdentifierTypeStateIssuer
00G624520MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050317000551 CA Part B Supplier - Clinic/Group Practice 7618922113 Receives reassigned benefits from 5 practitioners
Practice locations: Monterey Park, CA

National Provider Directory

National Provider Directory

Locations

600 N Garfield Ave
Ste 11
Monterey Park, CA 91754

600 N Garfield Ave
Ste 111
Monterey Park, CA 91754
Phone (626) 280-3651

Practitioners & affiliated clinicians

Practitioners 5

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": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587600000000",
    "number": "1124051578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N GARFIELD AVE",
            "address_2": "SUITE 111",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541166",
            "telephone_number": "626-280-3651",
            "fax_number": "626-280-3079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N GARFIELD AVE",
            "address_2": "SUITE 111",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541166",
            "telephone_number": "626-280-3651",
            "fax_number": "626-280-3079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M.D. MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-280-3651",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G62452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G624520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.