Individual provider Active NPI

Manuel Zevallos, MD

  • Hematology & Oncology Physician
  • Lynwood, CA
National Provider Identifier
1174611750
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A35871 Issued in CA
Practice address
3628 E Imperial Hwy Ste 401
Lynwood, CA 90262-2646
Phone
(310) 667-4000
Fax
(310) 667-4010
NPI assigned
Oct 10, 2006
Last updated
Apr 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A35871 CA
Hematology & Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RH0003X A35871 CA Primary

Addresses

Primary practice location

3628 E Imperial Hwy Ste 401
Lynwood, CA 90262-2646

Mailing address

18000 Studebaker Rd Ste 800
Cerritos, CA 90703-2671
Phone (562) 735-3226

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
I20100311000213 CA Practitioner - Hematology/Oncology 6800931163 Reassigns benefits to 1 organization
Practice locations: Lynwood, CA

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3628 E Imperial Hwy
Suite 401
Lynwood, CA 90262-2646
Phone (310) 667-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A35871CAMDSpecialist

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: manuel.zevallos@theoncologyinstitute.ikm.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1174611750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18000 STUDEBAKER RD STE 800",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032671",
            "telephone_number": "562-735-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3628 E IMPERIAL HWY STE 401",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622646",
            "telephone_number": "310-667-4000",
            "fax_number": "310-667-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEVALLOS",
        "first_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A35871",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A35871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.