Santos Flavio Pacheco, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A54292 Issued in CA

Practice address

15159 Prairie Ave
Lawndale, CA 90260-2210

Phone

(310) 644-7964

Fax

(310) 644-7989

NPI assigned

Nov 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Santos F. Pacheco MD Inc.

  • Family Medicine Physician
  • Inglewood, CA
  • NPI 1417217928
  Medicare reassignment NPD Authorized official
• Prime Healthcare Centinela, LLC

  • General Acute Care Hospital
  • Inglewood, CA
  • NPI 1336328244
  NPD (past)

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330041600000",
    "number": "1881765048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15159 PRAIRIE AVE",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902602210",
            "telephone_number": "310-644-7964",
            "fax_number": "310-644-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15159 PRAIRIE AVE",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902602210",
            "telephone_number": "310-644-7964",
            "fax_number": "310-644-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "SANTOS",
        "middle_name": "FLAVIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2012-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A54292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A542920",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A542922",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oloo Medical Supply
• Online Urgent Care, Inc.
• Yessenia Isamar Ortega Ramirez, NP
• Ashley Kaleiwehiokalani Oshiro
• Anthony Otegbulu
• Pandya Professional Dental Corporation
• Toral S Pandya, DDS
• Therese Jamie Parado, D.D.S.
• Park, D.M.D., Corp.
• Sunghae Park, DMD

• General Practice Physician in Lawndale, CA
• Providers in Lawndale, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.