Organization Active NPI

Marina Raikhel M D a Medical Corporation

  • Family Medicine Physician
  • Lomita, CA
National Provider Identifier
1497739734
Registry record updated Dec 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A49056 Issued in CA
Legal business name
MARINA RAIKHEL M D A MEDICAL CORPORATION
Practice address
25043 Narbonne Ave
Lomita, CA 90717-2101
Phone
(310) 373-8120
Fax
(424) 203-8980
NPI assigned
Nov 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2009

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

Authorized official

Name
Dr. Marina Raikhel, MDNPI 1073792446
Title
Director
Phone
(310) 373-8120

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A49056 CA Primary

Addresses

Primary practice location

25043 Narbonne Ave
Lomita, CA 90717-2101

Mailing address

25043 Narbonne Ave
Lomita, CA 90717-2101
Phone (310) 373-8120

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090423000481 CA Part B Supplier - Clinic/Group Practice 8325196777 Receives reassigned benefits from 3 practitioners
Practice locations: Lomita, CA

National Provider Directory

National Provider Directory

Locations

25043 Narbonne Ave
Lomita, CA 90717
Phone (310) 373-8120

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262044800000",
    "number": "1497739734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25043 NARBONNE AVE",
            "city": "LOMITA",
            "state": "CA",
            "postal_code": "907172101",
            "telephone_number": "310-373-8120",
            "fax_number": "424-203-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25043 NARBONNE AVE",
            "city": "LOMITA",
            "state": "CA",
            "postal_code": "907172101",
            "telephone_number": "310-373-8120",
            "fax_number": "424-203-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA RAIKHEL M D A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2009-12-29",
        "status": "A",
        "authorized_official_last_name": "RAIKHEL",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "310-373-8120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A49056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lomita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; 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.