NPIMap

Organization Active NPI

Concert Health Care Inc

  • Internal Medicine Physician
  • Torrance, CA
National Provider Identifier
1265859805
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A77702 Issued in CA
Legal business name
CONCERT HEALTH CARE INC
Practice address
1727 Crenshaw Blvd
Torrance, CA 90501
Phone
(310) 373-7855
Fax
(424) 704-2493
NPI assigned
Mar 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Authorized official

Name
Dr. Richard Montero Butlig, MDNPI 1912968447
Title
President
Phone
(310) 373-7855

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 PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X A77702 CA Primary
Hospitalist PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208M00000X A77702 CA

Addresses

Primary practice location

1727 Crenshaw Blvd
Torrance, CA 90501

Mailing address

1727 Crenshaw Blvd
Torrance, CA 90501
Phone (310) 373-7855

Other identifiers 1

IdentifierTypeStateIssuer
A77702MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140815001763 CA Part B Supplier - Clinic/Group Practice 6002033925 Receives reassigned benefits from 6 practitioners
Practice locations: Torrance, CA

National Provider Directory

National Provider Directory

Locations

1000 E Dominguez St
Ste 110
Carson, CA 90746
Phone (310) 715-7755

Practitioners & affiliated clinicians

Practitioners 6

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": "1395273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1265859805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 CRENSHAW BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90501",
            "telephone_number": "310-373-7855",
            "fax_number": "424-704-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 CRENSHAW BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90501",
            "telephone_number": "310-373-7855",
            "fax_number": "424-704-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCERT HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-20",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "BUTLIG",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "MONTERO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-373-7855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A77702",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A77702",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A77702",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.