Manuel Acevedo Medical Group, a Medical Corporation

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A74961 Issued in CA

Legal business name

MANUEL ACEVEDO MEDICAL GROUP, A MEDICAL CORPORATION

Practice address

1830 W Olympic Blvd
Ste. 124
Los Angeles, CA 90006-3734

Phone

(213) 637-9080

Fax

(213) 637-9084

NPI assigned

Oct 24, 2007

Organization subpart

No

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

Authorized official

Name

Loreto M Acevedo-Carmona

Title

Business Manager/Administrator

Phone

(213) 637-9080

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1538348727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 W OLYMPIC BLVD",
            "address_2": "STE. 124",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900063734",
            "telephone_number": "213-637-9080",
            "fax_number": "213-637-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 W OLYMPIC BLVD",
            "address_2": "STE. 124",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900063734",
            "telephone_number": "213-637-9080",
            "fax_number": "213-637-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANUEL ACEVEDO MEDICAL GROUP, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "ACEVEDO-CARMONA",
        "authorized_official_first_name": "LORETO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUSINESS MANAGER/ADMINISTRATOR",
        "authorized_official_telephone_number": "213-637-9080"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A74961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Bradley Edward Manubay, D.O.
• Venkat Sanjay Reddy Manubolu, MD
• Manuel G. Domantaydds, Inc
• Manuel Masaganda Ferreras (All State Optical)
• Carla Manuel-Gomez
• Carlon Laurence Manuel
• Gale M Manuel, LVN

• General Practice Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.