Individual provider Active NPI

Lawrence Vincent Presley, MD

  • Anesthesiology Physician
  • Long Beach, CA
National Provider Identifier
1275787533
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A109976 Issued in CA
Practice address
3711 Long Beach Blvd Ste 101a
Long Beach, CA 90807-3300
Phone
(562) 242-2527
NPI assigned
Nov 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A109976 CA Primary

Addresses

Primary practice location

3711 Long Beach Blvd Ste 101a
Long Beach, CA 90807-3300

Mailing address

PO Box 3098
Torrance, CA 90510-3098
Phone (310) 792-3914

Other identifiers 1

IdentifierTypeStateIssuer
1275787533MedicaidCA

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
I20100121000529 CA Practitioner - Anesthesiology 7911048913 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A109976CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Bay Anesthesia Medical Group Inc. Anesthesiology CurrentSince Dec 24, 2017 Accepting new patients
Anesthesia Medical Group of Santa Maria Inc Anesthesiology Past Accepting new patients

Locations

4101 Torrance Blvd
Torrance, CA 90503
Phone (310) 540-7676

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1275787533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3098",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905103098",
            "telephone_number": "310-792-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 LONG BEACH BLVD STE 101A",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073300",
            "telephone_number": "562-242-2527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESLEY",
        "first_name": "LAWRENCE",
        "middle_name": "VINCENT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-12",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A109976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275787533",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.