NPIMap

Organization Active NPI

Raju H Wadhwa

Doing business as El Segundo Family Medical Group

  • Internal Medicine Physician
  • Manhattan Beach, CA
National Provider Identifier
1457305963
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A50651 Issued in CA
Legal business name
RAJU H WADHWA
Doing business as
El Segundo Family Medical Group
Practice address
855 Manhattan Beach Blvd
Suite 104
Manhattan Beach, CA 90266-4965
Phone
(310) 939-1892
Fax
(310) 939-1894
NPI assigned
May 20, 2006
Last updated
Jun 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Dr. Raju H Wadhwa, M.D.NPI 1023006103
Title
Owner
Phone
(310) 939-1892

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
Internal Medicine Physician 207R00000X A50651 CA Primary

Addresses

Primary practice location

855 Manhattan Beach Blvd
Suite 104
Manhattan Beach, CA 90266-4965

Mailing address

855 Manhattan Beach Blvd
Suite 104
Manhattan Beach, CA 90266-4965
Phone (310) 939-1892

Other names 1

  • EL SEGUNDO FAMILY MEDICAL GROUP Doing business as

National Provider Directory

National Provider Directory

Locations

855 Manhattan Beach Blvd
Ste 104
Manhattan Beach, CA 90266
Phone (310) 939-1892

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 1

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": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1457305963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 MANHATTAN BEACH BLVD",
            "address_2": "SUITE 104",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902664965",
            "telephone_number": "310-939-1892",
            "fax_number": "310-939-1894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 MANHATTAN BEACH BLVD",
            "address_2": "SUITE 104",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902664965",
            "telephone_number": "310-939-1892",
            "fax_number": "310-939-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAJU H WADHWA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "WADHWA",
        "authorized_official_first_name": "RAJU",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-939-1892",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A50651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EL SEGUNDO FAMILY MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manhattan Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.