Organization Active NPI

Luis a. Galdamez, MD Inc.

  • Physician Assistant
  • Huntington Park, CA
National Provider Identifier
1225168024
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15773 Issued in CA
Legal business name
LUIS A. GALDAMEZ, MD INC.
Practice address
2955 E Florence Ave
Huntington Park, CA 90255-5836
Phone
(323) 585-0732
Fax
(323) 585-1673
NPI assigned
Mar 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Corina Ayers
Title
Administrator
Phone
(323) 585-0732

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X A050144 CA
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X A048644 CA
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA17148 CA
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA12501 CA
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA15773 CA Primary

Addresses

Primary practice location

2955 E Florence Ave
Huntington Park, CA 90255-5836

Mailing address

2955 E Florence Ave
Huntington Park, CA 90255-5836
Phone (323) 585-0732

Other identifiers 1

IdentifierTypeStateIssuer
GR0067940MedicaidCA

Other names 1

  • Clinica Medica Virgen de Guadalupe Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041228000291 CA Part B Supplier - Clinic/Group Practice 7810955655 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Huntington Park, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2955 E Florence Ave
Huntington Pk, CA 90255
Phone (323) 585-0732

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1225168024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 E FLORENCE AVE",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902555836",
            "telephone_number": "323-585-0732",
            "fax_number": "323-585-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 E FLORENCE AVE",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902555836",
            "telephone_number": "323-585-0732",
            "fax_number": "323-585-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIS A. GALDAMEZ, MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "AYERS",
        "authorized_official_first_name": "CORINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "323-585-0732"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A050144",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A048644",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17148",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA12501",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0067940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinica Medica Virgen de Guadalupe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntington Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.