Organization Active NPI

Healthy Foundations Medical Group

  • Pediatrics Physician
  • Compton, CA
National Provider Identifier
1235552886
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A45589 Issued in CA
Legal business name
HEALTHY FOUNDATIONS MEDICAL GROUP
Practice address
555 W Compton Blvd
Suite 205
Compton, CA 90220-3085
Phone
(310) 223-0684
Fax
(310) 223-0687
NPI assigned
Jan 31, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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

Authorized official

Name
Dr. Ejike C. Onyeador, M.D.
Title
Medical Director / Owner
Phone
(310) 223-0684

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X A45589 CA Primary

Addresses

Primary practice location

555 W Compton Blvd
Suite 205
Compton, CA 90220-3085

Mailing address

1045 Atlantic Ave
Suite 715
Long Beach, CA 90813-3408
Phone (562) 983-5496

Other identifiers 1

IdentifierTypeStateIssuer
A45589MedicaidCA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0907394Healthy Foundations Medical Group555 W Compton Blvd Suite 205, Compton, CA 90220Certificate of waiverFeb 19, 2027

National Provider Directory

National Provider Directory
Tax ID family
Healthy Foundations Medical Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1391126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403136000000",
    "number": "1235552886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 ATLANTIC AVE",
            "address_2": "SUITE 715",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133408",
            "telephone_number": "562-983-5496",
            "fax_number": "562-216-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W COMPTON BLVD",
            "address_2": "SUITE 205",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902203085",
            "telephone_number": "310-223-0684",
            "fax_number": "310-223-0687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY FOUNDATIONS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-31",
        "last_updated": "2014-06-19",
        "status": "A",
        "authorized_official_last_name": "ONYEADOR",
        "authorized_official_first_name": "EJIKE",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR / OWNER",
        "authorized_official_telephone_number": "310-223-0684",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A45589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A45589",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Compton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.