Individual provider Active NPI

Ada Elena Del Rivero Yamuy, M.D.

  • Family Medicine Physician
  • Culver City, CA
National Provider Identifier
1275676363
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A83694 Issued in CA
Practice address
3831 Hughes Ave
Suite 101
Culver City, CA 90232-2751
Phone
(310) 204-0104
Fax
(310) 204-0171
NPI assigned
Feb 15, 2007
Last updated
Jan 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A83694 CA Primary

Addresses

Primary practice location

3831 Hughes Ave
Suite 101
Culver City, CA 90232-2751

Mailing address

4815 Patrae St
Los Angeles, CA 90066-6726
Phone (310) 305-4157

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040109000674 CA Practitioner - General Practice 5991605677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Shahin S. Rad, M.D. PC CurrentSince Mar 26, 2025 Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients

Locations

3831 Hughes Ave
Ste 101
Culver City, CA 90232
Phone (310) 204-0104

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADDEBD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1275676363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 PATRAE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900666726",
            "telephone_number": "310-305-4157",
            "fax_number": "310-305-4157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3831 HUGHES AVE",
            "address_2": "SUITE 101",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322751",
            "telephone_number": "310-204-0104",
            "fax_number": "310-204-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL RIVERO YAMUY",
        "first_name": "ADA",
        "middle_name": "ELENA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A83694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.