Individual provider Active NPI

Raul Lopez, M.D.

  • Emergency Medicine Physician
  • Montebello, CA
National Provider Identifier
1124089701
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G73384 Issued in CA
Practice address
309 W Beverly Blvd
Montebello, CA 90640-4308
Phone
(818) 340-9988
Fax
(818) 587-2493
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G73384 CA Primary

Addresses

Primary practice location

309 W Beverly Blvd
Montebello, CA 90640-4308

Mailing address

4103 Sea View LN
Los Angeles, CA 90065-3334
Phone (323) 683-8389

Other identifiers 1

IdentifierTypeStateIssuer
00G733840MedicaidCA

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
I20040602001424 CA Practitioner - Emergency Medicine 0446232524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, Geffen School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6006 Whittier Blvd
Los Angeles, CA 90022-4402
Phone (323) 725-6292

Hospital & facility affiliations

  • Adventist Health White Memorial Hospital, Los Angeles, CA, CCN 050103

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G73384CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine CurrentSince Jul 1, 2009 Accepting new patients
Overhead Sun CurrentSince May 31, 2026 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jul 1, 2009 Accepting new patients
Sin Fronteras Health and Wellness Center CurrentSince Aug 8, 2019 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Anaheim Global Medical Center, Inc Past Accepting new patients
Sin Fronteras Medical Clinic PastSince Feb 27, 2021 Accepting new patients

Locations

751 Medical Center Ct
#1182
Chula Vista, CA 91911

4521 E Cesar E Chavez Ave
Los Angeles, CA 90022
Phone (323) 269-4509

6006 Whittier Blvd
Los Angeles, CA 90022
Phone (323) 725-6292

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

309 W Beverly Blvd
Montebello, CA 90640
Phone (323) 725-4209

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

Organizations & group practices 7

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1124089701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4103 SEA VIEW LN",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900653334",
            "telephone_number": "323-683-8389",
            "fax_number": "323-269-4509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404308",
            "telephone_number": "818-340-9988",
            "fax_number": "818-587-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "RAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G73384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G733840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

Verify at the official NPI Registry.