Madison Park Family Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G56001 Issued in CA

Legal business name

MADISON PARK FAMILY MEDICAL GROUP, INC.

Practice address

1970 So Prospect Ave
Ste 3
Redondo Beach, CA 90277

Phone

(310) 944-9344

Fax

(310) 944-9390

NPI assigned

Dec 9, 2005

Organization subpart

No

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

Authorized official

Name

Eduardo J Anorga, MD

Title

MD

Phone

(310) 944-9344

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439424000000",
    "number": "1932184223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 SO PROSPECT AVE",
            "address_2": "STE 3",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "90277",
            "telephone_number": "310-944-9344",
            "fax_number": "310-944-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 SO PROSPECT AVE",
            "address_2": "STE 3",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "90277",
            "telephone_number": "310-944-9344",
            "fax_number": "310-944-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON PARK FAMILY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-09",
        "last_updated": "2015-08-13",
        "status": "A",
        "authorized_official_last_name": "ANORGA",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "310-944-9344",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G56001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP M CARE #",
            "identifier": "W13994",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Macgugan
• Stacey Jo Mackaman, LMFT
• Mona Madani, M.D.
• Madison Park Family Medical
• Madison Park Family Medical Group
• Malina Maeda
• Robert Frank Maffucci, MPT
• Sarina Maghsoudy Louyeh
• Peggy Gray Magnusson, D.P.M.
• Lea Magsayo, LMT

• Family Medicine Physician in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; 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.