Individual provider Active NPI

Cathleen Hyun Marquez

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1609129170
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA52723 Issued in CA
Practice address
5970 S Central Ave
Los Angeles, CA 90001-1150
Phone
(323) 234-3280
Fax
(323) 234-3493
NPI assigned
Oct 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA52723 CA Primary

Addresses

Primary practice location

5970 S Central Ave
Los Angeles, CA 90001-1150

Mailing address

1000 San Gabriel Blvd Ste 200
Rosemead, CA 91770-4394
Phone (323) 724-0019

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191011001767 CA Practitioner - Physician Assistant 8820243041 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
52723CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Central City Community Health Center Inc CurrentSince Oct 13, 2019 Accepting new patients
Complete Care Community Health Center, Inc CurrentSince Apr 30, 2020 Accepting new patients
Complete Care Community Health Center, Inc CurrentSince Apr 30, 2020 Accepting new patients
Central City Community Health Center Inc General Practice Past Accepting new patients

Locations

5970 S Central Ave
Los Angeles, CA 90001
Phone (213) 234-3280

2928 E Cesar E Chavez Ave
Los Angeles, CA 90033
Phone (323) 266-6700

5233 E Beverly Blvd
Los Angeles, CA 90022
Phone (323) 499-3650

3000 S Robertson Blvd
Ste 280
Los Angeles, CA 90034

2019 Saturn St
Monterey Park, CA 91755
Phone (323) 724-0019

1000 San Gabriel Blvd
Ste 200
Rosemead, CA 91770
Phone (323) 724-0019

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1350864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1609129170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SAN GABRIEL BLVD STE 200",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917704394",
            "telephone_number": "323-724-0019",
            "fax_number": "323-248-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5970 S CENTRAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900011150",
            "telephone_number": "323-234-3280",
            "fax_number": "323-234-3493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "CATHLEEN",
        "middle_name": "HYUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-22",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA52723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.