Individual provider Active NPI

Christopher McDougal, M.D.

  • Emergency Medicine Physician
  • Long Beach, CA
National Provider Identifier
1568400463
Registry record updated Oct 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G38413 Issued in CA
Practice address
2776 Pacific Ave
Emergency Department
Long Beach, CA 90806-2613
Phone
(562) 595-1911
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G38413 CA Primary

Addresses

Primary practice location

2776 Pacific Ave
Emergency Department
Long Beach, CA 90806-2613

Mailing address

4551 Glencoe Ave
Suite 260
Marina del Rey, CA 90292-6385
Phone (310) 301-2030

Other identifiers 1

IdentifierTypeStateIssuer
00G384130MedicaidCA

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
I20050611000066 CA Practitioner - Emergency Medicine 6800830886 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G38413CAMDEmergency Medicine Physician
38413CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Emergency Medical Associates, Inc Emergency Medicine CurrentSince Sep 7, 2009 Accepting new patients

Locations

2776 Pacific Ave
Long Beach, CA 90806
Phone (562) 595-1911

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256169600000",
    "number": "1568400463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4551 GLENCOE AVE",
            "address_2": "SUITE 260",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926385",
            "telephone_number": "310-301-2030",
            "fax_number": "310-306-5247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2776 PACIFIC AVE",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062613",
            "telephone_number": "562-595-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOUGAL",
        "first_name": "CHRISTOPHER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2009-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G38413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G384130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.