Organization Active NPI

Randy Hawkins, M.D., Inc

  • Internal Medicine Physician
  • Inglewood, CA
National Provider Identifier
1225357155
Registry record updated May 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G49354 Issued in CA
Legal business name
RANDY HAWKINS, M.D., INC
Practice address
644 E Regent St
#200
Inglewood, CA 90301-1433
Phone
(310) 674-1970
Fax
(310) 674-7712
NPI assigned
May 17, 2010
Last updated
May 17, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2010

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

Authorized official

Name
Dr. Randy Hawkins, M.D.NPI 1760580971
Title
President
Phone
(310) 674-1970

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G49354 CA Primary
Pulmonary Disease Physician 207RP1001X G49354 CA

Addresses

Primary practice location

644 E Regent St
#200
Inglewood, CA 90301-1433

Mailing address

6709 La Tijera Blvd
#500
Los Angeles, CA 90045-2017
Phone (310) 674-1970

Other identifiers 1

IdentifierTypeStateIssuer
00G493540MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100603000683 CA Part B Supplier - Clinic/Group Practice 6103955950 Receives reassigned benefits from 1 practitioner
Practice locations: Inglewood, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274054400000",
    "number": "1225357155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6709 LA TIJERA BLVD",
            "address_2": "#500",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900452017",
            "telephone_number": "310-674-1970",
            "fax_number": "310-674-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "644 E REGENT ST",
            "address_2": "#200",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011433",
            "telephone_number": "310-674-1970",
            "fax_number": "310-674-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDY HAWKINS, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-17",
        "last_updated": "2010-05-17",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-674-1970",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G49354",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G49354",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G493540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2010; 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.