Individual provider Active NPI

Luis G Magdaleno, MD

  • Family Medicine Physician
  • San Pedro, CA
National Provider Identifier
1164492013
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G47888 Issued in CA
Practice address
900 N Western Ave
San Pedro, CA 90732-2427
Phone
(310) 832-4225
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G47888 CA Primary

Addresses

Primary practice location

900 N Western Ave
San Pedro, CA 90732-2427

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Other practice location 1

824 E Carson St Ste 104
Carson, CA 90745-2262
Phone (310) 830-9706

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
I20100616000266 CA Practitioner - Family Practice 4082744131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

25210 Crenshaw Blvd
Suite 100
Torrance, CA 90505-6134
Phone (424) 528-6028

3565 Del Amo Blvd
Torrance, CA 90503-1637
Phone (310) 214-0811

824 E Carson St
Suite 104
Carson, CA 90745-2262
Phone (310) 830-9706

900 N Western Ave
San Pedro, CA 90732-2427
Phone (310) 832-4225

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G47888CAMDFamily Medicine Physician
47888CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Family Medicine CurrentSince Dec 1, 2018 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Dec 1, 2018 Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Memorial Medical Group Inc Past Accepting new patients
Providence Health System Southern California Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

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

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

168 W Carson St
Carson, CA 90745
Phone (310) 233-3202

29409 S Western Ave
Rancho Palos Verdes, CA 90275
Phone (310) 784-6848

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

900 N Western Ave
San Pedro, CA 90732
Phone (310) 832-4225

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

3275 Skypark Dr
Torrance, CA 90505
Phone (310) 223-7813

3500 Lomita Blvd
Ste 203
Torrance, CA 90505
Phone (310) 326-0210

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: lmagdaleno206880@westdirect.optum.com

Organizations & group practices 6

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 3

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1164492013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N WESTERN AVE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907322427",
            "telephone_number": "310-832-4225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "824 E Carson St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Carson",
            "state": "CA",
            "postal_code": "907452262",
            "country_code": "US",
            "telephone_number": "310-830-9706",
            "fax_number": "310-831-4860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAGDALENO",
        "first_name": "LUIS",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G47888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

Verify at the official NPI Registry.