Individual provider Active NPI

Peter Katona, M.D.

  • Infectious Disease Physician
  • Marina del Rey, CA
National Provider Identifier
1750300364
Registry record updated May 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
G043505 Issued in CA
Practice address
4650 Lincoln Blvd
Marina del Rey, CA 90292-6306
Phone
(310) 208-1967
Fax
(866) 341-1049
NPI assigned
Jul 18, 2006
Last updated
May 23, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G43505 CA
Infectious Disease Physician 207RI0200X G043505 CA Primary

Addresses

Primary practice location

4650 Lincoln Blvd
Marina del Rey, CA 90292-6306

Mailing address

PO Box 81
Los Alamitos, CA 90720-0081
Phone (562) 420-9202

Other identifiers 1

IdentifierTypeStateIssuer
00G435050MedicaidCA

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
I20100902000178 CA Practitioner - Infectious DiseasePractitioner - Internal Medicine 6709914385 Practice locations: Marina del Rey, CA; Santa Monica, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G43505CAMDInternal Medicine Physician
G043505CAMDInfectious Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495497600000",
    "number": "1750300364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907200081",
            "telephone_number": "562-420-9202",
            "fax_number": "866-341-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 LINCOLN BLVD",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926306",
            "telephone_number": "310-208-1967",
            "fax_number": "866-341-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATONA",
        "first_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2017-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G43505",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "G043505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G435050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

Verify at the official NPI Registry.