Individual provider Active NPI

Douglas Mayfield, MD

  • Anesthesiology Physician
  • Los Angeles, CA
National Provider Identifier
1174636245
Registry record updated Jun 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G70267 Issued in CA
Practice address
5900 W Olympic Blvd
Los Angeles, CA 90036-4671
Phone
(310) 657-5900
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G70267 CA Primary

Addresses

Primary practice location

5900 W Olympic Blvd
Los Angeles, CA 90036-4671

Mailing address

210 N Tustin Ave
Santa Ana, CA 92705-3807
Phone (800) 883-7243

Other identifiers 1

IdentifierTypeStateIssuer
00G702670MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G70267CAMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245628800000",
    "number": "1174636245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "800-883-7243",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 W OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364671",
            "telephone_number": "310-657-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYFIELD",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2009-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G70267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G702670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; 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.