Eleby R. Washington III MD PC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

G53301 Issued in CA

Legal business name

ELEBY R. WASHINGTON III MD PC

Practice address

4644 Lincoln Blvd
Suite 101
Marina del Rey, CA 90292-6313

Phone

(310) 577-8500

Fax

(310) 305-7119

NPI assigned

Jan 17, 2012

Last updated

Jan 17, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ann Eguchi

Title

Biller

Phone

(310) 577-8500

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eleby Rudolph Washington III, M.D.

  • Orthopaedic Surgery Physician
  • Marina del Rey, CA
  • NPI 1154315273
  NPD (past)

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326758400000",
    "number": "1154692507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4644 LINCOLN BLVD",
            "address_2": "SUITE 101",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926313",
            "telephone_number": "310-577-8500",
            "fax_number": "310-305-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4644 LINCOLN BLVD",
            "address_2": "SUITE 101",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926313",
            "telephone_number": "310-577-8500",
            "fax_number": "310-305-7119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEBY R. WASHINGTON III MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-17",
        "last_updated": "2012-01-17",
        "status": "A",
        "authorized_official_last_name": "EGUCHI",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "310-577-8500"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G53301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.