Organization Active NPI

Julius C. Kpaduwa Medical Corporation

Doing business as Mother and Child Health Center

  • Specialist
  • La Puente, CA
National Provider Identifier
1780733048
Registry record updated Nov 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G51500 Issued in CA
Legal business name
JULIUS C. KPADUWA MEDICAL CORPORATION
Doing business as
Mother and Child Health Center
Practice address
15913 Amar Rd
La Puente, CA 91744-2202
Phone
(626) 330-9535
Fax
(626) 330-2661
NPI assigned
Jan 9, 2007
Last updated
Nov 27, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2017

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

Authorized official

Name
Julius C Kpaduwa, MDNPI 1578630125
Title
Owner
Phone
(626) 330-9535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X G51500 CA Primary

Addresses

Primary practice location

15913 Amar Rd
La Puente, CA 91744-2202

Mailing address

15913 Amar Rd
La Puente, CA 91744-2202
Phone (626) 330-9535

Other identifiers 3

IdentifierTypeStateIssuer
G51500OtherCAM.D
A56261OtherCAM.D
GR0085700MedicaidCA

Other names 1

  • Mother and Child Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100414000982 CA Part B Supplier - Clinic/Group Practice 6305973835 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
Practice locations: El Monte, CA; La Puente, CA

Other NPIs on the same Medicare enrollment 2

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
05D1039840Julius C Kpaduwa MD Medical Corp Inc15913 Amar Rd, La Puente, CA 91744Certificate of waiverApr 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Julius C Kpaduwa Medical Corporation2 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.

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": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511740800000",
    "number": "1780733048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15913 AMAR RD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917442202",
            "telephone_number": "626-330-9535",
            "fax_number": "626-330-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15913 AMAR RD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917442202",
            "telephone_number": "626-330-9535",
            "fax_number": "626-330-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIUS C. KPADUWA MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2017-11-27",
        "status": "A",
        "authorized_official_last_name": "KPADUWA",
        "authorized_official_first_name": "JULIUS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-330-9535",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G51500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M.D",
            "identifier": "G51500",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M.D",
            "identifier": "A56261",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0085700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mother and Child Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Puente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2017; 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.