Greater Long Beach Genito-Urinary Med GRP

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

Organization subpart

No

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

Specialties & licenses 1

Addresses

Other identifiers 13

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jules M Perley, M.D.

  • Urology Physician
  • Lakewood, CA
  • NPI 1801865381
  Medicare reassignment Care Compare group NPD Authorized official
• Thomas Calvert, M.D.

  • Urology Physician
  • Lakewood, CA
  • NPI 1982042677
  Medicare reassignment Care Compare group NPD
• Shalini Thomas Malickal, DNP, APRN, FNP

  • Family Nurse Practitioner
  • Long Beach, CA
  • NPI 1184454654
  Medicare reassignment Care Compare group NPD
• Jonathan E Perley, M.D.

  • Urology Physician
  • Lakewood, CA
  • NPI 1326017831
  Medicare reassignment Care Compare group NPD
• Andrew Charles Burg, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Lake Forest, CA
  • NPI 1366523805
  Medicare reassignment NPD

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PROVI",
            "identifier": "WG22223B",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PROVI",
            "identifier": "WG54806D",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN INDIVIDUAL PIN",
            "identifier": "1497724900",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN INDIVIDUAL UPIN",
            "identifier": "1326017831",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PROVI",
            "identifier": "WA76527B",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PROVI",
            "identifier": "WG54806C",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "G22223",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "G54806",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN INDIVIDUAL PIN",
            "identifier": "1801865381",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A76527",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0049180",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PROVI",
            "identifier": "WA76527A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PROVI",
            "identifier": "WG22223A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana Granados
• Aubrey Grandon
• Diane Marie Grant, D.C.
• Akeyva Gray
• Lisa Gray
• James Green, LMFT
• Navrose S Grewal, M.D.
• Aubrey Gross
• Nicholas Guan
• Daisy J. Guevara, MD

• Urology Physician in Lakewood, CA
• Providers in Lakewood, CA by specialty
• Urology Physician in California

• 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.