Active NPI
Ronald Castillo Tejada Jr., MD
- Internal Medicine Physician
- Carson, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A118334
- Practice address
- 20920 Chico St
Carson, CA 90746-3603 - Phone
- (424) 444-5097
- Fax
- (833) 973-3630
- NPI assigned
- Sep 30, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A118334 | CA | Primary |
| Internal Medicine Physician | 207R00000X | 036130801 | IL |
Addresses
Primary practice location
20920 Chico St
Carson, CA 90746-3603
Mailing address
3300 E South St
Suite 205
Lakewood, CA 90805-4549
Phone (562) 531-0377
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036130801 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthcare Partners Affiliates Medical Group | Current | Accepting new patients | |
| Healthcare Partners Affiliates Medical Group | Internal Medicine | Current | Accepting new patients |
| Jesse J Licuanan MD a Medical Corporation | Internal Medicine | Past | Accepting new patients |
| Memorial Medical Group Inc | Past | Accepting new patients |
Locations
1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000
5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864
2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600
824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706
9920 Talbert Ave
Fountain Vly, CA 92708
Phone (714) 236-4000
9930 Talbert Ave
Fountain Vly, CA 92708
Phone (714) 964-6229
1025 W Olympic Blvd
Los Angeles, CA 90015
Phone (213) 623-2225
3501 S Harbor Blvd
Santa Ana, CA 92704
Phone (714) 784-1658
1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1659312593
-
- Durable Medical Equipment & Medical Supplies
- Murrieta, CA
- NPI 1760057269
-
- Internal Medicine Physician
- Lakewood, CA
- NPI 1114218559
-
- Durable Medical Equipment & Medical Supplies
- Phoenix, AZ
- NPI 1255523643
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787702400000",
"number": "1407165079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 E SOUTH ST",
"address_2": "SUITE 205",
"city": "LAKEWOOD",
"state": "CA",
"postal_code": "908054549",
"telephone_number": "562-531-0377",
"fax_number": "562-531-1724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20920 CHICO ST",
"city": "CARSON",
"state": "CA",
"postal_code": "907463603",
"telephone_number": "424-444-5097",
"fax_number": "833-973-3630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEJADA",
"first_name": "RONALD",
"middle_name": "CASTILLO",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-30",
"last_updated": "2026-08-26",
"certification_date": "2026-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A118334",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036130801",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Carson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.