Individual provider Active NPI

Fred Kazuhiro Kurata, MD

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1205906740
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G49917 Issued in CA
Practice address
420 E 3Rd St
Ste 603
Los Angeles, CA 90013-1645
Phone
(213) 680-1551
Fax
(213) 680-2148
NPI assigned
Nov 9, 2006
Last updated
Oct 11, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G49917 CA Primary

Addresses

Primary practice location

420 E 3Rd St
Ste 603
Los Angeles, CA 90013-1645

Mailing address

420 E 3Rd St
Ste 603
Los Angeles, CA 90013-1645
Phone (213) 680-1551

Other identifiers 5

IdentifierTypeStateIssuer
GR0078582MedicaidCA
GR0078583MedicaidCA
GR0078581MedicaidCA
GR0078580MedicaidCA
00G499170MedicaidCA

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
I20101222000450 CA Practitioner - Ophthalmology 7517931413 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G49917CAMDSpecialist
49917CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
East-West Eye Institute a Medical Corporation CurrentSince Jan 1, 1997 Accepting new patients
East-West Eye Institute a Medical Corporation CurrentSince Jan 1, 1997 Accepting new patients
Terraces Surgery Center LLC Current Accepting new patients
Third Street Surgery Center LLC PastSince Oct 1, 2013 Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients
Gardena Hospital LP Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

75 Enterprise
Ste 200
Aliso Viejo, CA 92656
Phone (949) 554-4688

1300 W 155th St
Ste 104
Gardena, CA 90247
Phone (310) 329-9975

420 E 3rd St
Ste 603
Los Angeles, CA 90013
Phone (213) 625-2694

50 Alessandro Pl
Ste 150
Pasadena, CA 91105
Phone (626) 577-5437

23441 Madison St
Ste 120
Torrance, CA 90505
Phone (310) 370-3628

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1205906740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E 3RD ST",
            "address_2": "STE 603",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131645",
            "telephone_number": "213-680-1551",
            "fax_number": "213-680-2148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 3RD ST",
            "address_2": "STE 603",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131645",
            "telephone_number": "213-680-1551",
            "fax_number": "213-680-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURATA",
        "first_name": "FRED",
        "middle_name": "KAZUHIRO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G49917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0078582",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0078583",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0078581",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0078580",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G499170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.