Organization Active NPI

Children & Adults Med GR Inc

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1437200276
Registry record updated Feb 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A6867 Issued in CA
Legal business name
CHILDREN & ADULTS MED GR INC
Practice address
633 N Spring St
Ste #4
Los Angeles, CA 90012-2814
Phone
(213) 928-0866
Fax
(213) 928-0868
NPI assigned
Jan 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2010

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

Authorized official

Name
Dr. David Huu Nguyen, DONPI 1316017353
Title
Physician Owner Or President
Phone
(213) 928-0866

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 20A6867 CA Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 20A6867 CA

Addresses

Primary practice location

633 N Spring St
Ste #4
Los Angeles, CA 90012-2814

Mailing address

9246 E Valley Blvd
#C
Rosemead, CA 91770
Phone (626) 641-2117

Other identifiers 1

IdentifierTypeStateIssuer
00AX68671MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050523000801 CA Part B Supplier - Clinic/Group Practice 7315989142 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Los Angeles, CA; Rosemead, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Children Adult Medical Group Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1551 N Vermont Ave
Ste C
Los Angeles, CA 90027
Phone (323) 913-3333

633 N Spring St
Ste 4
Los Angeles, CA 90012
Phone (213) 928-0866

9246 Valley Blvd
Ste A
Rosemead, CA 91770
Phone (626) 376-5560

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267142400000",
    "number": "1437200276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9246 E VALLEY BLVD",
            "address_2": "#C",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "91770",
            "telephone_number": "626-641-2117",
            "fax_number": "626-573-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 N SPRING ST",
            "address_2": "STE #4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900122814",
            "telephone_number": "213-928-0866",
            "fax_number": "213-928-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN & ADULTS MED GR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2010-02-26",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "HUU",
        "authorized_official_title_or_position": "PHYSICIAN OWNER OR PRESIDENT",
        "authorized_official_telephone_number": "213-928-0866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A6867",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A6867",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX68671",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.