Luzviminda T Montecillo MD a Professional Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A52290 Issued in CA

Legal business name

LUZVIMINDA T MONTECILLO MD A PROFESSIONAL CORPORATION

Practice address

645 Aerick Street
Suite 1
Inglewood, CA 90301-4882

Phone

(310) 673-2764

Fax

(310) 673-2403

NPI assigned

Nov 1, 2006

Last updated

Mar 18, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Oscar Tagorda, DO

Title

Office Manager

Phone

(310) 673-2764

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Medicare enrollment (NPD)

Not enrolled

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Luzviminda T. Montecillo, MD

  • Internal Medicine Physician
  • Inglewood, CA
  • NPI 1447348149
  Medicare reassignment NPD

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584489600000",
    "number": "1285711812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 AERICK ST STE 1",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014882",
            "telephone_number": "310-673-2764",
            "fax_number": "310-673-2403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 AERICK STREET",
            "address_2": "SUITE 1",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014882",
            "telephone_number": "310-673-2764",
            "fax_number": "310-673-2403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUZVIMINDA T MONTECILLO MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A",
        "authorized_official_last_name": "TAGORDA",
        "authorized_official_first_name": "OSCAR",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "310-673-2764",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A52290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A522900",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Luxottica Retail North America Inc (Target Optical #4955)
• Luz a. Herrera Physician Assistant Inc
• Doris E Lyonga, MD
• M.a.C.K. Making Abilities Count With Kindness
• Maat (Gravity Wellness BHS)
• Maat (Gravity Wellnes)
• Thi Mach, CAS

• Internal Medicine Physician in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.