NPIMap

Organization Active NPI

Redondo Emergency Physicians, Inc.

  • Emergency Medicine Physician
  • Gardena, CA
National Provider Identifier
1376834937
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
REDONDO EMERGENCY PHYSICIANS, INC.
Practice address
1145 W Redondo Beach Blvd
Gardena, CA 90247-3528
Phone
(310) 321-0143
Fax
(310) 379-4856
NPI assigned
Apr 29, 2011
Last updated
Dec 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Authorized official

Name
Matthew A. Dugard, MDNPI 1700911070
Title
Authorized Official
Phone
(310) 321-0143

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

1145 W Redondo Beach Blvd
Gardena, CA 90247-3528

Mailing address

PO Box 80633
City of Industry, CA 91716-8412
Phone (310) 321-0143

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110804000471 CA Part B Supplier - Clinic/Group Practice 9032388269 Receives reassigned benefits from 59 practitioners
Practice locations: Gardena, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 70

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 70

NPI Registry JSON

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

{
    "created_epoch": "1304035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702512000000",
    "number": "1376834937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80633",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917168412",
            "telephone_number": "310-321-0143",
            "fax_number": "310-379-4856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 W REDONDO BEACH BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473528",
            "telephone_number": "310-321-0143",
            "fax_number": "310-379-4856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDONDO EMERGENCY PHYSICIANS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-29",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A",
        "authorized_official_last_name": "DUGARD",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "310-321-0143",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.