Individual provider Active NPI

Jasmine Eugenio, MD

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1285768242
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A66392 Issued in CA
Practice address
12021 Wilmington Ave
Los Angeles, CA 90059-3019
Phone
(310) 668-4515
Fax
(310) 763-8909
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A66392 CA Primary

Addresses

Primary practice location

12021 Wilmington Ave
Los Angeles, CA 90059-3019

Mailing address

13518 Charlwood Cir
Cerritos, CA 90703-6322

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
I20130716000825 CA Practitioner - Pediatric Medicine 3577703479 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Dec 3, 2025 Accepting new patients
County of Los Angeles CurrentSince Dec 3, 2025 Accepting new patients

Locations

1000 S Fremont Ave
Bldg A11
Alhambra, CA 91803
Phone (626) 457-4240

1670 E 120th St
Los Angeles, CA 90059
Phone (424) 338-1000

12021 Wilmington Ave
Los Angeles, CA 90059
Phone (310) 668-4515

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285768242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13518 CHARLWOOD CIR",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 WILMINGTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593019",
            "telephone_number": "310-668-4515",
            "fax_number": "310-763-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUGENIO",
        "first_name": "JASMINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A66392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.