Individual provider Active NPI

Ruth C Demonteverde, M.D.

  • Pediatric Adolescent Medicine Physician
  • Manhattan Beach, CA
National Provider Identifier
1891875001
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
G54370 Issued in CA
Practice address
500 S Sepulveda Blvd Ste 205
Manhattan Beach, CA 90266-6976
Phone
(310) 318-1608
Fax
(310) 318-2988
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
Yes

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
Pediatric Adolescent Medicine Physician 2080A0000X G54370 CA Primary

Addresses

Primary practice location

500 S Sepulveda Blvd Ste 205
Manhattan Beach, CA 90266-6976

Mailing address

500 S Sepulveda Blvd Ste 205
Manhattan Beach, CA 90266-6976
Phone (310) 318-1608

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G54370CAMDPediatric Adolescent Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891875001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S SEPULVEDA BLVD STE 205",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902666976",
            "telephone_number": "310-318-1608",
            "fax_number": "310-318-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S SEPULVEDA BLVD STE 205",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902666976",
            "telephone_number": "310-318-1608",
            "fax_number": "310-318-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMONTEVERDE",
        "first_name": "RUTH",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CA",
            "license": "G54370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.