Individual provider Active NPI

Juan Miguel Andrade, MD

  • Otology & Neurotology Physician
  • Huntington Park, CA
National Provider Identifier
1740308907
Registry record updated Jun 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otology & Neurotology PhysicianTaxonomy code 207YX0901X
License
A38298 Issued in CA
Practice address
2613 Saturn Avenue
Huntington Park, CA 90255
Phone
(323) 588-7371
Fax
(323) 588-1427
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otology & Neurotology Physician 207YX0901X A38298 CA Primary
Otolaryngology Physician 207Y00000X A38298 CA

Addresses

Primary practice location

2613 Saturn Avenue
Huntington Park, CA 90255

Mailing address

PO Box 830
Alhambra, CA 91802-0830
Phone (323) 588-7371

Other identifiers 1

IdentifierTypeStateIssuer
A38298OtherCAMEDICAL LICENSE

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
I20040607000810 CA Practitioner - Otolaryngology 1557343050 Practice locations: Huntington Park, CA

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2613 Saturn Ave
Huntington Park, CA 90255-4129
Phone (323) 588-7371

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A38298CAMDOtolaryngology Physician

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276819200000",
    "number": "1740308907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 830",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918020830",
            "telephone_number": "323-588-7371",
            "fax_number": "323-588-1427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2613 SATURN AVENUE",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "90255",
            "telephone_number": "323-588-7371",
            "fax_number": "323-588-1427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRADE",
        "first_name": "JUAN",
        "middle_name": "MIGUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2010-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "CA",
            "license": "A38298",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A38298",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A38298",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Park, CA

Sources for this page

Verify at the official NPI Registry.