Individual provider Active NPI

Beatriz Lares, M.D

  • Specialist
  • Downey, CA
National Provider Identifier
1700098381
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G43240 Issued in CA
Practice address
9360 Telegraph Rd
Downey, CA 90240-2425
Phone
(562) 869-0180
Fax
(562) 869-0984
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G43240 CA Primary

Addresses

Primary practice location

9360 Telegraph Rd
Downey, CA 90240-2425

Mailing address

9360 Telegraph Rd
Downey, CA 90240-2425
Phone (562) 869-0180

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
I20040304001150 CA Practitioner - General PracticePractitioner - Pediatric Medicine 8426946278 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G43240CAMDSpecialist
43420CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tubi Connect Inc. CurrentSince Oct 1, 2021 Accepting new patients
Omni Family Health PastSince Nov 19, 2021 Accepting new patients
Amistad Multi Specialty Medical Group Inc. Past Accepting new patients
R Srinivasan MD Inc Past Accepting new patients

Locations

8950 Villa La Jolla Dr
Ste C117
La Jolla, CA 92037
Phone (858) 997-7415

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1700098381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9360 TELEGRAPH RD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902402425",
            "telephone_number": "562-869-0180",
            "fax_number": "562-869-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9360 TELEGRAPH RD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902402425",
            "telephone_number": "562-869-0180",
            "fax_number": "562-869-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARES",
        "first_name": "BEATRIZ",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G43240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.