NPIMap

Organization Active NPI

Centers for Family Medicine GP

Doing business as Optumcare Medical Group

  • Family Medicine Physician
  • Los Alamitos, CA
National Provider Identifier
1467598243
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CENTERS FOR FAMILY MEDICINE GP
Doing business as
Optumcare Medical Group
Practice address
3460 Katella Ave
Los Alamitos, CA 90720-2334
Phone
(562) 594-6599
Fax
(562) 598-6220
NPI assigned
Jan 29, 2007
Last updated
Aug 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Authorized official

Name
Emily Castillo
Title
Associate Director
Phone
(702) 480-2550

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
Endocrinology, Diabetes & Metabolism Physician 207RE0101X
Obstetrics & Gynecology Physician 207V00000X
Pediatrics Physician 208000000X
Hospitalist Physician 208M00000X

Addresses

Primary practice location

3460 Katella Ave
Los Alamitos, CA 90720-2334

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 480-2550

Other names 1

  • OPTUMCARE MEDICAL GROUP Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050614000191 CA Part B Supplier - Clinic/Group Practice 9931143799 Receives reassigned benefits from 260 practitioners
Practice locations: Vista, CA; Anaheim, CA; Seal Beach, CA; San Juan Capistrano, CA; San Clemente, CA; Rancho Santa Margarita, CA; Orange, CA; Los Alamitos, CA…

National Provider Directory

National Provider Directory

Locations

761 S Weir Canyon Rd
Ste 185
Anaheim, CA 92808
Phone (714) 282-6934

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

26740 Towne Centre Dr
Foothill Ranch, CA 92610
Phone (949) 588-9293

24331 El Toro Rd
Ste 300
Laguna Woods, CA 92637
Phone (949) 588-8700

13930 Seal Beach Blvd
Seal Beach, CA 90740
Phone (562) 430-8888

Practitioners & affiliated clinicians

Practitioners 456

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.

View all 456

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1467598243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-480-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 KATELLA AVE",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202334",
            "telephone_number": "562-594-6599",
            "fax_number": "562-598-6220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERS FOR FAMILY MEDICINE GP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR",
        "authorized_official_telephone_number": "702-480-2550"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OPTUMCARE MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.