NPIMap

Individual provider Active NPI

Maria Lourdes Castanos De Leon, M.D.

  • General Practice Physician
  • South Gate, CA
National Provider Identifier
1285775437
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A73468 Issued in CA
Practice address
9916 San Juan Ave
South Gate, CA 90280-6108
Phone
(323) 564-1100
Fax
(323) 564-1133
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A73468 CA
General Practice Physician 208D00000X A73468 CA Primary

Addresses

Primary practice location

9916 San Juan Ave
South Gate, CA 90280-6108

Mailing address

2933 Whittier Blvd
Los Angeles, CA 90023-1528
Phone (323) 263-2669

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080123000858 CA Practitioner - Family PracticePractitioner - General PracticePractitioner - Internal MedicinePractitioner - Pediatric MedicinePractitioner - Geriatric Medicine 3971685355 Reassigns benefits to 5 organizations
Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice, Geriatric Medicine, Internal Medicine, Pediatric Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mobile Medical Group Inc.Group PAC ID 8224397963, 12 clinicians
Bella Medical Group IncGroup PAC ID 0042473779, 2 clinicians

Practice addresses (Care Compare)

130 N Brand Blvd
Suite 208
Glendale, CA 91203-2627
Phone (818) 945-6003

2933 Whittier Blvd
Los Angeles, CA 90023-1528
Phone (323) 263-2669

9916 San Juan Ave
South Gate, CA 90280-6108
Phone (323) 564-1100

Hospital & facility affiliations

  • Cipher Home Health Home health agency, Burbank, CA, CCN 757218
  • La Home Healthcare, Inc Home health agency, Glendale, CA, CCN 559481
  • Progress Home Health Care Inc Home health agency, Glendale, CA, CCN 553171
  • Infinity Homecare Agency, Inc Home health agency, Canoga Park, CA, CCN 559141
  • Rejuvenate Home Health Inc. Home health agency, Burbank, CA, CCN 757000
  • Rejuvenate Hospice Care Inc Hospice, Rancho Cucamonga, CA, CCN 551713
  • Evolve Hospice, Inc Hospice, Reseda, CA, CCN B51524
  • A-One Hospice Providers, Inc Hospice, Chino, CA, CCN 751558
  • Zenith Hospice Hospice, Panorama City, CA, CCN B31671
  • Adlife Hospice Inc. Hospice, Cerritos, CA, CCN B21722

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A73468CAMDGeneral Practice Physician

Practice roles (5 of 6)

OrganizationSpecialtyStatusNew patients
Mobile Medical Group Inc CurrentSince Feb 20, 2020 Accepting new patients
California Mobile Doctors Group Inc CurrentSince Jan 22, 2024 Accepting new patients
California Mobile Medical Group Inc CurrentSince May 29, 2024 Accepting new patients
Bella Medical Group Inc CurrentSince Feb 23, 2020 Accepting new patients
Family Home Health Care Inc PastSince Nov 1, 2018 Accepting new patients

Locations

655 N Central Ave
Ste 1734
Glendale, CA 91203
Phone (818) 945-6003

130 N Brand Blvd
Ste 208
Glendale, CA 91203
Phone (818) 945-6003

8619 Reseda Blvd
Ste 201
Northridge, CA 91324
Phone (747) 217-8863

9916 San Juan Ave
South Gate, CA 90280
Phone (323) 564-1100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432166400000",
    "number": "1285775437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2933 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900231528",
            "telephone_number": "323-263-2669",
            "fax_number": "323-263-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9916 SAN JUAN AVE",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806108",
            "telephone_number": "323-564-1100",
            "fax_number": "323-564-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LEON",
        "first_name": "MARIA LOURDES",
        "middle_name": "CASTANOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2015-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A73468",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A73468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Gate, CA

Sources for this page

Verify at the official NPI Registry.