Jed Padre MD Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JED PADRE MD INC

Practice address

282 E Sepulveda Blvd
Carson, CA 90745-6323

Phone

(310) 518-6861

Fax

(310) 835-1366

NPI assigned

Sep 14, 2020

Organization subpart

No

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

Authorized official

Name

Jed Padre, MDNPI 1285169110

Title

Owner

Phone

(310) 518-6861

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Jed Padre, MD

  • Family Medicine Physician
  • Carson, CA
  • NPI 1285169110
  Medicare reassignment Care Compare group NPD Authorized official
• Diane Padre-Gozun

  • Family Medicine Physician
  • Carson, CA
  • NPI 1457858714
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600041600000",
    "number": "1225643448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 E SEPULVEDA BLVD",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907456323",
            "telephone_number": "310-518-6861",
            "fax_number": "310-835-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 E SEPULVEDA BLVD",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907456323",
            "telephone_number": "310-518-6861",
            "fax_number": "310-835-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JED PADRE MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A",
        "authorized_official_last_name": "PADRE",
        "authorized_official_first_name": "JED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-518-6861",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Srisha Anil Jhangiani, PA-C
• Karla Mariana Jimenez Munoz

• Family Medicine Physician in Carson, CA
• Providers in Carson, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.