Madison Park Family Medical

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A7340 Issued in CA

Legal business name

MADISON PARK FAMILY MEDICAL

Practice address

1970 So Prospect Ave
Suite 3
Redondo Beach, CA 90277

Phone

(310) 944-9344

Fax

(310) 944-9390

NPI assigned

Dec 2, 2005

Organization subpart

No

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

Authorized official

Name

Neda Bayat, DO

Title

DO

Phone

(310) 944-9344

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Madison Park Family Medical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Madison Park Family Medical Group

  • Family Medicine Physician
  • Redondo Beach, CA
  • NPI 1437352325
  NPD tax ID

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194912000000",
    "number": "1760466700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 SO PROSPECT AVE",
            "address_2": "SUITE 3",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "90277",
            "telephone_number": "310-944-9344",
            "fax_number": "310-944-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 SO PROSPECT AVE",
            "address_2": "SUITE 3",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "90277",
            "telephone_number": "310-944-9344",
            "fax_number": "310-944-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON PARK FAMILY MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-02",
        "last_updated": "2007-11-13",
        "status": "A",
        "authorized_official_last_name": "BAYAT",
        "authorized_official_first_name": "NEDA",
        "authorized_official_title_or_position": "DO",
        "authorized_official_telephone_number": "310-944-9344",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A7340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MCARE",
            "identifier": "W13994",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Ma, OD
• Marta Maaza, RN
• Matthew Macgugan
• Stacey Jo Mackaman, LMFT
• Mona Madani, M.D.
• Madison Park Family Medical Group
• Madison Park Family Medical Group, Inc.
• Malina Maeda
• Robert Frank Maffucci, MPT
• Sarina Maghsoudy Louyeh

• Family Medicine Physician in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.