Individual provider Active NPI

Rehana Minoli Hethumuni, D.O.

  • Adult Medicine Physician
  • Montebello, CA
National Provider Identifier
1518054477
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
20A8993 Issued in CA
Practice address
101 E. Beverly Blvd, Suite 404
Montebello, CA 90640
Phone
(626) 676-6038
Fax
(323) 722-0158
NPI assigned
Oct 10, 2006
Last updated
Oct 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 20A8993 CA Primary

Addresses

Primary practice location

101 E. Beverly Blvd, Suite 404
Montebello, CA 90640

Mailing address

101 E. Beverly Blvd, Suite 404
Montebello, CA 90640
Phone (626) 676-6038

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
I20070810000652 CA Practitioner - Family Practice 6800987488 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A8993CAMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Adult Medicine Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Oct 30, 2006 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Oct 30, 2006 Accepting new patients
Pasadena Family Medicine Inc Adult Medicine PastSince Sep 1, 2004 Accepting new patients
Avail Health Medical Group PC PastSince Jun 28, 2024 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

1025 W Olympic Blvd
Los Angeles, CA 90015
Phone (213) 623-2225

401 S Fair Oaks Ave
Pasadena, CA 91105
Phone (323) 720-1144

675 S Arroyo Pkwy
Pasadena, CA 91105
Phone (626) 585-4120

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rehana.hethumuni.p76@direct.healthcarepartners.nextgenshare.com
  • Direct secure messaging: rehanahethumuni@hcpca.allscriptsdirect.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1518054477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E. BEVERLY BLVD, SUITE 404",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "90640",
            "telephone_number": "626-676-6038",
            "fax_number": "323-722-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E. BEVERLY BLVD, SUITE 404",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "90640",
            "telephone_number": "626-676-6038",
            "fax_number": "323-722-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETHUMUNI",
        "first_name": "REHANA",
        "middle_name": "MINOLI",
        "name_prefix": "Ms.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "20A8993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

Verify at the official NPI Registry.