NPIMap

Organization Active NPI

Madison Park Family Medical Group

  • Family Medicine Physician
  • Redondo Beach, CA
National Provider Identifier
1437352325
Registry record updated Jul 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G56001 Issued in CA
Legal business name
MADISON PARK FAMILY MEDICAL GROUP
Practice address
1970 S Prospect Ave
Redondo Beach, CA 90277-6005
Phone
(310) 944-9344
Fax
(310) 944-9390
NPI assigned
Jun 7, 2007
Last updated
Jul 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2007

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

Authorized official

Name
Eduardo J Anorga, MDNPI 1235312752
Title
Proprietor
Phone
(310) 944-9344

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X G56001 CA Primary

Addresses

Primary practice location

1970 S Prospect Ave
Redondo Beach, CA 90277-6005

Mailing address

1970 S Prospect Ave
Redondo Beach, CA 90277-6005
Phone (310) 944-9344

National Provider Directory

National Provider Directory
Tax ID family
Madison Park Family Medical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1970 S Prospect Ave
Redondo Beach, CA 90277
Phone (310) 316-0020

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 2

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": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185494400000",
    "number": "1437352325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 S PROSPECT AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902776005",
            "telephone_number": "310-944-9344",
            "fax_number": "310-944-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 S PROSPECT AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902776005",
            "telephone_number": "310-944-9344",
            "fax_number": "310-944-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON PARK FAMILY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-07-27",
        "status": "A",
        "authorized_official_last_name": "ANORGA",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "310-944-9344",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G56001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.