Individual provider Active NPI

John Sunderson, M.D.

  • Obstetrics & Gynecology Physician
  • Redondo Beach, CA
National Provider Identifier
1144257692
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A042066 Issued in CA
Practice address
601 Torrance Blvd
Redondo Beach, CA 90277-3416
Phone
(310) 792-8317
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A042066 CA Primary

Addresses

Primary practice location

601 Torrance Blvd
Redondo Beach, CA 90277-3416

Mailing address

701 Ruby St
Redondo Beach, CA 90277-3849
Phone (310) 543-1298

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
I20060928000537 CA Practitioner - Obstetrics/Gynecology 6608871447 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A042066CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2004 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2004 Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

601 Torrance Blvd
Redondo Beach, CA 90277
Phone (310) 316-0811

Interoperability endpoints

  • Direct secure messaging: johnsunderson@hcpca.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1144257692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 RUBY ST",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773849",
            "telephone_number": "310-543-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 TORRANCE BLVD",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773416",
            "telephone_number": "310-792-8317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDERSON",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A042066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.