Active NPI
Laurence Ikuo Ikeda, M.D.
- Pediatrics Physician
- Huntington Beach, CA
National Provider Identifier
1376814418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G55607
- Practice address
- 19311 Coralwood LN
Huntington Beach, CA 92646-2623 - Phone
- (714) 963-3123
- NPI assigned
- Jan 20, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G55607 | CA | Primary |
Addresses
Primary practice location
19311 Coralwood LN
Huntington Beach, CA 92646-2623
Mailing address
19311 Coralwood LN
Huntington Beach, CA 92646-2623
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G55607 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327017600000",
"number": "1376814418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19311 CORALWOOD LN",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926462623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19311 CORALWOOD LN",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926462623",
"telephone_number": "714-963-3123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IKEDA",
"first_name": "LAURENCE",
"middle_name": "IKUO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-20",
"last_updated": "2012-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G55607",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.