Organization Active NPI

Corday Medical Group

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1821266354
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G31116 Issued in CA
Legal business name
CORDAY MEDICAL GROUP
Practice address
8635 W 3Rd St Ste 485W
Los Angeles, CA 90048-6156
Phone
(310) 855-8081
NPI assigned
Feb 19, 2008
Organization subpart
Yes
Parent organization
CORDAY AND CORDAYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Authorized official

Name
Dr. Stephen R Corday, M.D.NPI 1194759803
Title
Doctor
Phone
(310) 855-8081

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 G31116 CA Primary

Addresses

Primary practice location

8635 W 3Rd St Ste 485W
Los Angeles, CA 90048-6156

Mailing address

8635 W 3Rd St Ste 485W
Los Angeles, CA 90048-6156
Phone (310) 855-8081

Other identifiers 3

IdentifierTypeStateIssuer
ZZZ82542ZMedicaidCA
ZZZ53071YOtherCABLUE SHIELD OF CALIFORNIA
010034153OtherRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050414001233 CA Part B Supplier - Clinic/Group Practice 4880631399 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

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
05D0544614Corday Medical Group Lab8635 W 3Rd St Ste 485W, Los Angeles, CA 90048ComplianceJan 1, 2028

National Provider Directory

National Provider Directory

Locations

8639 W Third St
790W
Los Angeles, CA 90048

8639 W 3Rd St
790W
Los Angeles, CA 90048

8635 W 3rd St
Ste 485
West Hollywood, CA 90048
Phone (310) 652-9162

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1821266354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST STE 485W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486156",
            "telephone_number": "310-855-8081",
            "fax_number": "310-855-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST STE 485W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486156",
            "telephone_number": "310-855-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORDAY MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORDAY AND CORDAY",
        "enumeration_date": "2008-02-19",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "CORDAY",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "310-855-8081",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G31116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ82542Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZ53071Y",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "010034153",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.