Individual provider Active NPI

George Joseph Rederich, M.D.

  • Neurology Physician
  • Redondo Beach, CA
National Provider Identifier
1649212309
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G36414 Issued in CA
Practice address
520 N Prospect Ave
Suite 309
Redondo Beach, CA 90277-3041
Phone
(310) 376-9492
Fax
(310) 376-0848
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X G36414 CA Primary

Addresses

Primary practice location

520 N Prospect Ave
Suite 309
Redondo Beach, CA 90277-3041

Mailing address

520 N Prospect Ave
Suite 309
Redondo Beach, CA 90277-3041
Phone (310) 376-9492

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G36414CAMDNeurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649212309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVE",
            "address_2": "SUITE 309",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773041",
            "telephone_number": "310-376-9492",
            "fax_number": "310-376-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVE",
            "address_2": "SUITE 309",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773041",
            "telephone_number": "310-376-9492",
            "fax_number": "310-376-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDERICH",
        "first_name": "GEORGE",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G36414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.