Individual provider Active NPI

Luke R Watson, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Long Beach, CA
National Provider Identifier
1881768653
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
G60383 Issued in CA
Practice address
2776 Pacific Ave
Long Beach, CA 90806
Phone
(562) 997-2232
Fax
(562) 997-2238
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X G60383 CA Primary

Addresses

Primary practice location

2776 Pacific Ave
Long Beach, CA 90806

Mailing address

5856 Corporate Ave
Suite 200
Cypress, CA 90630
Phone (714) 236-4000

Other identifiers 1

IdentifierTypeStateIssuer
00G603830MedicaidCA

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
I20031215000621 CA Practitioner - Pathology 1355248774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2623 E Slauson Ave
Huntington Park, CA 90255-2926
Phone (323) 583-3338

2776 Pacific Ave
Long Beach, CA 90806-2613
Phone (562) 997-2500

Hospital & facility affiliations

  • Memorial Hospital of Gardena Hospital, Gardena, CA, CCN 050468
  • College Medical Center Hospital, Long Beach, CA, CCN 050776
  • Foothill Regional Medical Center Hospital, Tustin, CA, CCN 050780
  • Community Hospital of Huntington Park Hospital, Huntington Park, CA, CCN 050091
  • Coast Plaza Hospital Hospital, Norwalk, CA, CCN 050771

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Luke R Watson MD Inc Anatomic Pathology & Clinical Pathology CurrentSince Oct 16, 2004 Accepting new patients

Locations

5856 Corporate Ave
Ste 200
Cypress, CA 90630
Phone (714) 236-4000

2776 Pacific Ave
Long Beach, CA 90806
Phone (562) 595-1911

2623 E Slauson Ave
Walnut Park, CA 90255
Phone (323) 277-5855

Organizations & group practices 1

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881768653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5856 CORPORATE AVE",
            "address_2": "SUITE 200",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "90630",
            "telephone_number": "714-236-4000",
            "fax_number": "714-236-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2776 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90806",
            "telephone_number": "562-997-2232",
            "fax_number": "562-997-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "LUKE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "G60383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G603830",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.