Organization Active NPI

Fujiwara Medical Group Inc.

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1437894870
Registry record updated Apr 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FUJIWARA MEDICAL GROUP INC.
Practice address
200 S San Pedro St Ste 302
Los Angeles, CA 90012-5308
Phone
(213) 680-0355
NPI assigned
Apr 30, 2022
Last updated
Apr 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2022

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

Authorized official

Name
John FujiwaraNPI 1992205926
Title
Manager
Phone
(213) 680-0355

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Adult Medicine Physician 207QA0505X
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X

Addresses

Primary practice location

200 S San Pedro St Ste 302
Los Angeles, CA 90012-5308

Mailing address

200 S San Pedro St Ste 302
Los Angeles, CA 90012-5308

Other identifiers 1

IdentifierTypeStateIssuer
0OtherNONE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221214003247 CA Part B Supplier - Clinic/Group Practice 5597134411 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2284465Fujiwara Medical Group Inc200 S San Pedro St Ste 302, Los Angeles, CA 90012Certificate of waiverJun 21, 2027

National Provider Directory

National Provider Directory

Locations

200 S San Pedro St
Ste 302
Los Angeles, CA 90012
Phone (213) 680-0355

Practitioners & affiliated clinicians

Practitioners 4

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": "1651276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651276800000",
    "number": "1437894870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S SAN PEDRO ST STE 302",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900125308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S SAN PEDRO ST STE 302",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900125308",
            "telephone_number": "213-680-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUJIWARA MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-30",
        "last_updated": "2022-04-30",
        "certification_date": "2022-04-30",
        "status": "A",
        "authorized_official_last_name": "FUJIWARA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "213-680-0355"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Apr 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.