NPIMap

Organization Active NPI

Greater Long Beach Genito-Urinary Med GRP

  • Urology Physician
  • Lakewood, CA
National Provider Identifier
1417976705
Registry record updated Jan 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
G22223 Issued in CA
Legal business name
GREATER LONG BEACH GENITO-URINARY MED GRP
Practice address
3650 South Street
Suite 408
Lakewood, CA 90712-1510
Phone
(562) 630-0423
Fax
(562) 630-0660
NPI assigned
Jul 18, 2006
Last updated
Jan 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2010

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

Authorized official

Name
Dr. Jules M Perley, MDNPI 1801865381
Title
MD/President
Phone
(562) 630-0423

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
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X G22223 CA Primary

Addresses

Primary practice location

3650 South Street
Suite 408
Lakewood, CA 90712-1510

Mailing address

3650 South Street
Suite 408
Lakewood, CA 90712-1510
Phone (562) 630-0423

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050803001227 CA Part B Supplier - Clinic/Group Practice 0143258723 Receives reassigned benefits from 5 practitioners
Practice locations: Lakewood, CA; Long Beach, CA; Los Alamitos, CA; Montebello, CA; Norwalk, CA

National Provider Directory

National Provider Directory

Locations

433 N 4th St
Ste 205
Montebello, CA 90640
Phone (323) 278-5525

620 W Beverly Blvd
Montebello, CA 90640
Phone (323) 869-0871

120 W Hellman Ave
Ste 304
Monterey Park, CA 91754

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263513600000",
    "number": "1417976705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 SOUTH STREET",
            "address_2": "SUITE 408",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121510",
            "telephone_number": "562-630-0423",
            "fax_number": "562-630-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 SOUTH STREET",
            "address_2": "SUITE 408",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121510",
            "telephone_number": "562-630-0423",
            "fax_number": "562-630-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER LONG BEACH GENITO-URINARY MED GRP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2010-01-15",
        "status": "A",
        "authorized_official_last_name": "PERLEY",
        "authorized_official_first_name": "JULES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD/PRESIDENT",
        "authorized_official_telephone_number": "562-630-0423",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "G22223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; 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.