Organization Active NPI

Green, Stuart & Marinow, Harry & Bonfilio, Nicholas & Feiwell, Lawrenc

  • Orthopaedic Surgery Physician
  • Los Alamitos, CA
National Provider Identifier
1275723629
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
GREEN, STUART & MARINOW, HARRY & BONFILIO, NICHOLAS & FEIWELL, LAWRENC
Practice address
3771 Katella Ave
Suite 310
Los Alamitos, CA 90720-3115
Phone
(562) 430-3561
Fax
(562) 431-8882
NPI assigned
Jul 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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

Authorized official

Name
Dr. Duke Ahn, M.D.
Title
Managing Partner
Phone
(562) 430-3561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

3771 Katella Ave
Suite 310
Los Alamitos, CA 90720-3115

Mailing address

1040 Elm Ave
Suite 100
Long Beach, CA 90813-3265
Phone (562) 591-4444

Other identifiers 4

IdentifierTypeStateIssuer
GR0066741MedicaidCA
W13148AOtherOTHER PTAN
W13148BOtherPTAN
ZZZ53512ZOtherCABLUE SHIELD PIN NUMBER

Other names 1

  • GREATER LONG BEACH ORTHOPAEDIC SURGICAL & MEDICAL GROUP A PTRSHP Doing business as

National Provider Directory

National Provider Directory

Locations

1661 Golden Rain Rd
Bldg D
Seal Beach, CA 90740
Phone (562) 493-9581

Practitioners & affiliated clinicians

Practitioners 3

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": "1185840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359676800000",
    "number": "1275723629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 ELM AVE",
            "address_2": "SUITE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133265",
            "telephone_number": "562-591-4444",
            "fax_number": "562-436-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3771 KATELLA AVE",
            "address_2": "SUITE 310",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203115",
            "telephone_number": "562-430-3561",
            "fax_number": "562-431-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN, STUART & MARINOW, HARRY & BONFILIO, NICHOLAS & FEIWELL, LAWRENC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-31",
        "last_updated": "2013-02-01",
        "status": "A",
        "authorized_official_last_name": "AHN",
        "authorized_official_first_name": "DUKE",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "562-430-3561",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0066741",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER PTAN",
            "identifier": "W13148A",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "W13148B",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN NUMBER",
            "identifier": "ZZZ53512Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREATER LONG BEACH ORTHOPAEDIC SURGICAL & MEDICAL GROUP A PTRSHP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.