Individual provider Active NPI

Martha Esperanza Rodas Maldonado, MD

  • Family Medicine Physician
  • Harbor City, CA
National Provider Identifier
1467193011
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A189378 Issued in CA
Practice address
1403 Lomita Blvd Ste 102
Harbor City, CA 90710-2084
Phone
(310) 602-2600
NPI assigned
Apr 6, 2022
Last updated
Jul 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X A189378 CA Primary

Addresses

Primary practice location

1403 Lomita Blvd Ste 102
Harbor City, CA 90710-2084

Mailing address

1403 Lomita Blvd Ste 102
Harbor City, CA 90710-2084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250724001375 CA Order and Referring Only - Family PracticePractitioner - Family Practice 7214443308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A189378CAMDFamily Medicine Physician

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1467193011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 LOMITA BLVD STE 102",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907102084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 LOMITA BLVD STE 102",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907102084",
            "telephone_number": "310-602-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODAS MALDONADO",
        "first_name": "MARTHA",
        "middle_name": "ESPERANZA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-06",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A189378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harbor City, CA

Sources for this page

Verify at the official NPI Registry.