Individual provider Active NPI

John David Millane, MD

  • Family Medicine Physician
  • Long Beach, CA
National Provider Identifier
1801879093
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G52798 Issued in CA
Practice address
4910 Airport Plaza Dr Ste 210
Long Beach, CA 90815-1377
Phone
(562) 421-3727
Fax
(562) 420-8948
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G52798 CA Primary

Addresses

Primary practice location

4910 Airport Plaza Dr Ste 210
Long Beach, CA 90815-1377

Mailing address

11 Technology Dr
Irvine, CA 92618-2302

Other practice location 1

5977 E Spring St
Long Beach, CA 90808-3752
Phone (562) 421-3727

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
I20091205000097 CA Practitioner - Family Practice 3779622618 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G52798CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Family Medicine GP Family Medicine CurrentSince Sep 17, 2011 Accepting new patients
Memorial Medical Group Inc Past Accepting new patients
Centers for Family Medicine - Fhclb Past Accepting new patients

Locations

11 Technology Dr
Irvine, CA 92618
Phone (855) 206-6764

5977 E Spring St
Long Beach, CA 90808
Phone (562) 421-3727

4910 Airport Plaza Dr
Ste 210
Long Beach, CA 90815
Phone (562) 421-3727

3460 Katella Ave
Los Alamitos, CA 90720
Phone (310) 594-6599

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1801879093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 TECHNOLOGY DR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182302",
            "fax_number": "855-812-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 AIRPORT PLAZA DR STE 210",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151377",
            "telephone_number": "562-421-3727",
            "fax_number": "562-420-8948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5977 E Spring St",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908083752",
            "country_code": "US",
            "telephone_number": "562-421-3727",
            "fax_number": "562-420-8948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLANE",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G52798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.