Individual provider Active NPI

Susan Reiko Kawakami, D.O.

  • Family Medicine Physician
  • Downey, CA
National Provider Identifier
1740212851
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A6720 Issued in CA
Practice address
8556 Florence Ave
Downey, CA 90240-4015
Phone
(562) 861-0101
Fax
(562) 861-9898
NPI assigned
Jul 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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
Family Medicine Physician 207Q00000X 20A6720 CA Primary

Addresses

Primary practice location

8556 Florence Ave
Downey, CA 90240-4015

Mailing address

8556 Florence Ave
Downey, CA 90240-4015
Phone (562) 861-0101

Other identifiers 1

IdentifierTypeStateIssuer
00AX67200MedicaidCA

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
I20060105000930 CA Practitioner - Family Practice 1658394556 Receives reassigned benefits from 1 practitioner
Practice locations: Downey, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A6720CAMDFamily Medicine Physician
20A6820CAMDInternal Medicine Physician
6720CAMDOccupational Therapist

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740212851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8556 FLORENCE AVE",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902404015",
            "telephone_number": "562-861-0101",
            "fax_number": "562-861-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8556 FLORENCE AVE",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902404015",
            "telephone_number": "562-861-0101",
            "fax_number": "562-861-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWAKAMI",
        "first_name": "SUSAN",
        "middle_name": "REIKO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX67200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.