Organization Active NPI

Good Life Medical Group Inc

  • Family Medicine Physician
  • Lakewood, CA
National Provider Identifier
1316940828
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A6005 Issued in CA
Legal business name
GOOD LIFE MEDICAL GROUP INC
Practice address
3650 South St Ste 204
Lakewood, CA 90712-1521
Phone
(562) 602-8841
Fax
(562) 602-8843
NPI assigned
May 31, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Authorized official

Name
Dr. Peter Hugh, D.O.NPI 1316035082
Title
C.E.O.
Phone
(562) 602-8841

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 20A6005 CA Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X A050818 CA

Addresses

Primary practice location

3650 South St Ste 204
Lakewood, CA 90712-1521

Mailing address

3650 South St Ste 204
Lakewood, CA 90712-1521
Phone (562) 602-8841

Other identifiers 1

IdentifierTypeStateIssuer
GR0092320MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031219000386 CA Part B Supplier - Clinic/Group Practice 0749188456 Receives reassigned benefits from 1 practitioner
Practice locations: Lakewood, CA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0999209Good Life Medical Group Inc3650 E South St Ste 204, Lakewood, CA 90712Certificate of waiverMay 6, 2028

National Provider Directory

National Provider Directory

Locations

5451 La Palma Ave
Ste 16
La Palma, CA 90623
Phone (562) 865-0210

3650 South St
Lakewood, CA 90712
Phone (562) 633-6353

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 1

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": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785456000000",
    "number": "1316940828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST STE 204",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121521",
            "telephone_number": "562-602-8841",
            "fax_number": "562-602-8843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST STE 204",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121521",
            "telephone_number": "562-602-8841",
            "fax_number": "562-602-8843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD LIFE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A",
        "authorized_official_last_name": "HUGH",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "562-602-8841",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6005",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A050818",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0092320",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; 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.