Henry D. DO, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A77453 Issued in CA

Practice address

11525 Brookshire Ave
Suite 301
Downey, CA 90241-4985

Phone

(562) 862-3684

Fax

(562) 862-7145

NPI assigned

May 25, 2006

Last updated

Jul 27, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Access Primary Care Physicians, Inc.

  dba AVA Health Partners

  • Family Medicine Physician
  • Whittier, CA
  • NPI 1750858510

  Internal Medicine

  Medicare reassignment NPD
• Caremore Medical Group

  • Physical Medicine & Rehabilitation Physician
  • Cerritos, CA
  • NPI 1770656829

  Internal Medicine

  NPD (past)
• Caremore Medical Group Inc

  • Family Medicine Physician
  • Cerritos, CA
  • NPI 1760435705

  Internal Medicine

  NPD (past)
• Rubin and McNamara MDS Inc

  • Hematology & Oncology Physician
  • La Mirada, CA
  • NPI 1659328219
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311724800000",
    "number": "1538115290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12900 PARK PLAZA DR",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907039329",
            "telephone_number": "562-741-4421",
            "fax_number": "562-741-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11525 BROOKSHIRE AVE",
            "address_2": "SUITE 301",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902414985",
            "telephone_number": "562-862-3684",
            "fax_number": "562-862-7145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "HENRY",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2011-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A77453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET ID #",
            "identifier": "106710",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ID #",
            "identifier": "00A774530",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A774530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Discovery Practice Management, Inc. (Center For Discovery & Adolescent Change)
• Monina Distor-Castro, RN, FNP-BC
• Divinity & Associates Inc (Divine Employment Services)
• Leylah Dixon
• Liene Marice L Dizon, RN
• Hoang-Anh Phung DO
• John-Khoa DO, D.O.
• Nancy T DO
• Stephanie DO
• Suzanne DO, N.P.

• Internal Medicine Physician in Downey, CA
• Providers in Downey, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.