Individual provider Active NPI

Lucero Teran, M.D.

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1326089277
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A88879 Issued in CA
Practice address
245 S Fetterly Ave
Los Angeles, CA 90022-1605
Phone
(232) 362-1010
NPI assigned
Jun 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A88879 CA Primary

Addresses

Primary practice location

245 S Fetterly Ave
Los Angeles, CA 90022-1605

Mailing address

245 S Fetterly Ave
Los Angeles, CA 90022-1605
Phone (232) 362-1010

Other identifiers 2

IdentifierTypeStateIssuer
00A888790MedicaidCA
00A888790OtherMEDI CAL

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
I20061201000543 CA Practitioner - Family Practice 5890793780 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A88879CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Aug 12, 2015 Accepting new patients
County of Los Angeles Current Accepting new patients
County of Los Angeles CurrentSince Aug 12, 2015 Accepting new patients
Molina Healthcare of California Family Medicine Past Accepting new patients
Molina Healthcare of California Family Medicine Past Accepting new patients
Molina Medical Centers Family Medicine Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

245 S Fetterly Ave
Los Angeles, CA 90022
Phone (323) 362-1010

Organizations & group practices 6

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1326089277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 S FETTERLY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221605",
            "telephone_number": "232-362-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 S FETTERLY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221605",
            "telephone_number": "232-362-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERAN",
        "first_name": "LUCERO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A88879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A888790",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "00A888790",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.