Individual provider Active NPI

Roberto T Unguez, MD

  • Cardiovascular Disease Physician
  • Carson, CA
National Provider Identifier
1780787283
Registry record updated Aug 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G11040 Issued in CA
Practice address
164 W Carson St
Carson, CA 90745-2601
Phone
(310) 518-3054
Fax
(310) 835-1366
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 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 G11040 CA
Cardiovascular Disease Physician 207RC0000X G11040 CA Primary

Addresses

Primary practice location

164 W Carson St
Carson, CA 90745-2601

Mailing address

2550 Pacific Coast Hwy
#44
Torrance, CA 90505-7726
Phone (310) 944-5632

Other identifiers 1

IdentifierTypeStateIssuer
00G110400MedicaidCA

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
I20120306000346 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2567621840 Reassigns benefits to 2 organizations
Practice locations: Carson, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11040CAMDMental Health Counselor
G11040CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Torrance Memorial Medical Center CurrentSince Aug 2, 2017 Accepting new patients
Torrance Memorial Medical Center CurrentSince Aug 2, 2017 Accepting new patients
Cor Healthcare Medical Associates Internal Medicine CurrentSince Aug 2, 2017 Accepting new patients

Locations

1360 W 6th St
Ste 315
San Pedro, CA 90732
Phone (310) 547-9922

3330 Lomita Blvd
Torrance, CA 90505
Phone (310) 517-4675

22617 Hawthorne Blvd
Torrance, CA 90505
Phone (310) 370-4700

2841 Lomita Blvd
Ste 100
Torrance, CA 90505
Phone (310) 257-0508

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502928000000",
    "number": "1780787283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 PACIFIC COAST HWY",
            "address_2": "#44",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905057726",
            "telephone_number": "310-944-5632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 W CARSON ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907452601",
            "telephone_number": "310-518-3054",
            "fax_number": "310-835-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNGUEZ",
        "first_name": "ROBERTO",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2017-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G11040",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G11040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G110400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

Verify at the official NPI Registry.