Individual provider Active NPI

Rafael T Retino, M.D.

  • Internal Medicine Physician
  • Mission Hills, CA
National Provider Identifier
1376643858
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A046422 Issued in CA
Practice address
11600 Indian Hills Rd
Mission Hills, CA 91345-1225
Phone
(818) 838-4590
Fax
(818) 838-7509
NPI assigned
Sep 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A046422 CA Primary

Addresses

Primary practice location

11600 Indian Hills Rd
Mission Hills, CA 91345-1225

Mailing address

11600 Indian Hills Rd
Mission Hills, CA 91345-1225
Phone (818) 838-4590

Other names 1

  • Jose Rafael T Retino Other name

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
I20110316000100 CA Practitioner - Internal Medicine 3678755469 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46422CAMDGeneral Practice Dentistry
A046422CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Internal Medicine Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Dec 1, 2001 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Dec 1, 2001 Accepting new patients

Locations

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

11600 Indian Hills Rd
Mission Hills, CA 91345
Phone (818) 781-7097

Organizations & group practices 3

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": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1376643858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 INDIAN HILLS RD",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451225",
            "telephone_number": "818-838-4590",
            "fax_number": "818-838-7509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 INDIAN HILLS RD",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451225",
            "telephone_number": "818-838-4590",
            "fax_number": "818-838-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETINO",
        "first_name": "RAFAEL",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A046422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSE RAFAEL",
            "last_name": "RETINO",
            "middle_name": "T",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mission Hills, CA

Sources for this page

Verify at the official NPI Registry.