Organization Active NPI

Minkes & Deere, M.D.'S

  • Surgery Physician
  • Downey, CA
National Provider Identifier
1659312411
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G54147 Issued in CA
Legal business name
MINKES & DEERE, M.D.'S
Practice address
11480 Brookshire Ave
Suite 111
Downey, CA 90241-5010
Phone
(562) 904-1651
Fax
(562) 904-1656
NPI assigned
Jun 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

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

Authorized official

Name
Mrs. Rita K Aguilar
Title
Office Manager
Phone
(562) 904-1651

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X G54147 CA Primary

Addresses

Primary practice location

11480 Brookshire Ave
Suite 111
Downey, CA 90241-5010

Mailing address

11480 Brookshire Ave
Suite 111
Downey, CA 90241-5010
Phone (562) 904-1651

Other identifiers 3

IdentifierTypeStateIssuer
GR00080690MedicaidCA
ZZZ54573ZOtherCABLUE SHIELD
GR0080690OtherCAMEDI-CAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040325001569 CA Part B Supplier - Clinic/Group Practice 3375435233 Receives reassigned benefits from 3 practitioners
Practice locations: Downey, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1659312411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11480 BROOKSHIRE AVE",
            "address_2": "SUITE 111",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902415010",
            "telephone_number": "562-904-1651",
            "fax_number": "562-904-1656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11480 BROOKSHIRE AVE",
            "address_2": "SUITE 111",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902415010",
            "telephone_number": "562-904-1651",
            "fax_number": "562-904-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINKES & DEERE, M.D.'S",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "AGUILAR",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "562-904-1651",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "G54147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR00080690",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ54573Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "GR0080690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.