Individual provider Active NPI

Viktor E Eysselein, M.D.

  • Gastroenterology Physician
  • Torrance, CA
National Provider Identifier
1609848191
Registry record updated May 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A48752 Issued in CA
Practice address
21840 Normandie Ave
Ste. 700
Torrance, CA 90502-2047
Phone
(310) 222-5101
Fax
(310) 320-5463
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A48752 CA Primary

Addresses

Primary practice location

21840 Normandie Ave
Ste. 700
Torrance, CA 90502-2047

Mailing address

21840 Normandie Ave Ste 400
Torrance, CA 90502-2047
Phone (310) 222-5101

Other identifiers 1

IdentifierTypeStateIssuer
00A487520MedicaidCA

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
I20101122000164 CA Practitioner - Gastroenterology 9436345188 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1124 W Carson St
Torrance, CA 90502-2006
Phone (310) 222-2773

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A48752CAMDGastroenterology Physician
48752CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners, a Medical Group, Inc. CurrentSince Aug 1, 2019 Accepting new patients
County of Los Angeles CurrentSince Jul 1, 1999 Accepting new patients
Prohealth Partners, a Medical Group Current Accepting new patients
County of Los Angeles CurrentSince Jul 1, 1999 Accepting new patients
Prohealth Partners, a Medical Group CurrentSince Aug 1, 2019 Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients
Prohealth Partners a Medical Group Inc Gastroenterology Past Accepting new patients
Harbor-UCLA Medical Foundation Inc. Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

21840 Normandie Ave
Torrance, CA 90502
Phone (310) 222-5015

3330 Lomita Blvd
Fl 5
Torrance, CA 90505
Phone (310) 517-4735

21840 Normandie Ave
Ste 400
Torrance, CA 90502

1124 W Carson St
Torrance, CA 90502
Phone (310) 222-2773

4201 Torrance Blvd
Ste 350
Torrance, CA 90503
Phone (310) 540-5494

4101 Torrance Blvd
Torrance, CA 90503
Phone (310) 540-7676

21840 Normandie Ave
Ste 100
Torrance, CA 90502
Phone (310) 222-5015

21840 Normandie Ave
Ste 700
Torrance, CA 90502
Phone (310) 222-5101

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

20911 Earl St
Ste 180
Torrance, CA 90503
Phone (310) 370-4660

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1609848191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21840 NORMANDIE AVE STE 400",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022047",
            "telephone_number": "310-222-5101",
            "fax_number": "310-320-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21840 NORMANDIE AVE",
            "address_2": "STE. 700",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022047",
            "telephone_number": "310-222-5101",
            "fax_number": "310-320-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EYSSELEIN",
        "first_name": "VIKTOR",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A48752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A487520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.