Organization Active NPI

Family Care Specialists Medical Corporation

  • Family Medicine Physician
  • Montebello, CA
National Provider Identifier
1740233725
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY CARE SPECIALISTS MEDICAL CORPORATION
Practice address
815 Washington Blvd
Montebello, CA 90640-6123
Phone
(323) 317-9200
Fax
(323) 728-6905
NPI assigned
May 18, 2006
Last updated
Mar 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Authorized official

Name
Mauricio Eduardo Bueno, MDNPI 1750332029
Title
Chief Medical Officer
Phone
(323) 791-0557

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

815 Washington Blvd
Montebello, CA 90640-6123

Mailing address

5823 York Blvd Ste 3
Los Angeles, CA 90042-2634
Phone (323) 317-9200

Other identifiers 4

IdentifierTypeStateIssuer
CQ2165OtherGARAILROAD MEDICARE GROUP
W10759AOtherCAMEDICARE GROUP ID
GR0040672OtherCAMEDICAID GROUP ID
ZZZ22101ZOtherCABLUE SHIELD GROUP ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050111001140 CA Part B Supplier - Clinic/Group Practice 6709834112 Receives reassigned benefits from 32 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Los Angeles, CA; Montebello, CA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0552262Family Care Specialists Med GRP Inc815 W Washington Boulevard, Montebello, CA 90640Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774915200000",
    "number": "1740233725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5823 YORK BLVD STE 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900422634",
            "telephone_number": "323-317-9200",
            "fax_number": "323-254-2158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 WASHINGTON BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906406123",
            "telephone_number": "323-317-9200",
            "fax_number": "323-728-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE SPECIALISTS MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A",
        "authorized_official_last_name": "BUENO",
        "authorized_official_first_name": "MAURICIO",
        "authorized_official_middle_name": "EDUARDO",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "323-791-0557",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "CQ2165",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID",
            "identifier": "W10759A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP ID",
            "identifier": "GR0040672",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP ID",
            "identifier": "ZZZ22101Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.