Individual provider Active NPI

Edna K Taikwel, M.D.

  • General Practice Physician
  • Monterey Park, CA
National Provider Identifier
1821044389
Registry record updated May 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A54127 Issued in CA
Practice address
705 E Garvey Ave
Monterey Park, CA 91755-3024
Phone
(626) 312-5488
Fax
(626) 312-5455
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A54127 CA
General Practice Physician 208D00000X A54127 CA Primary

Addresses

Primary practice location

705 E Garvey Ave
Monterey Park, CA 91755-3024

Mailing address

705 E Garvey Ave
Monterey Park, CA 91755-3024
Phone (626) 312-5488

Other identifiers 1

IdentifierTypeStateIssuer
00A541270MedicaidCA

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
I20041207000680 CA Practitioner - Pediatric Medicine 7911963343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

705 E Garvey Ave
Monterey Park, CA 91755-3024
Phone (626) 312-5488

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Garvey Healthy Family Medical Clinic, Inc Pediatrics CurrentSince Apr 8, 2013 Accepting new patients
Ahmc Garfield Medical Center LP Past Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients

Locations

705 E Garvey Ave
Monterey Park, CA 91755
Phone (626) 312-5488

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367366400000",
    "number": "1821044389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 E GARVEY AVE",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917553024",
            "telephone_number": "626-312-5488",
            "fax_number": "626-312-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 E GARVEY AVE",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917553024",
            "telephone_number": "626-312-5488",
            "fax_number": "626-312-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAIKWEL",
        "first_name": "EDNA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2013-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A54127",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A54127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A541270",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

Verify at the official NPI Registry.