NPIMap

Organization Active NPI

Celerina B Medina MD Inc

Doing business as Clinica Medina Medical Office

  • Family Medicine Physician
  • South Gate, CA
National Provider Identifier
1972749216
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A45547 Issued in CA
Legal business name
CELERINA B MEDINA MD INC
Doing business as
Clinica Medina Medical Office
Practice address
4149 Tweedy Blvd
Suite B
South Gate, CA 90280-6167
Phone
(323) 564-4545
Fax
(323) 564-3063
NPI assigned
Dec 16, 2008
Last updated
May 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2009

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

Authorized official

Name
Dr. Celerina Medina, M.D.NPI 1356399919
Title
President
Phone
(323) 564-4545

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A45547 CA Primary

Addresses

Primary practice location

4149 Tweedy Blvd
Suite B
South Gate, CA 90280-6167

Mailing address

4149 Tweedy Blvd
Suite B
South Gate, CA 90280-6167
Phone (323) 564-4545

Other identifiers 1

IdentifierTypeStateIssuer
00A45570MedicaidCA

Other names 1

  • CLINICA MEDINA MEDICAL OFFICE Doing business as

National Provider Directory

National Provider Directory

Locations

4149 Tweedy Blvd
Ste B
South Gate, CA 90280
Phone (323) 564-4545

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1972749216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4149 TWEEDY BLVD",
            "address_2": "SUITE B",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806167",
            "telephone_number": "323-564-4545",
            "fax_number": "323-564-3063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4149 TWEEDY BLVD",
            "address_2": "SUITE B",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806167",
            "telephone_number": "323-564-4545",
            "fax_number": "323-564-3063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CELERINA B MEDINA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-16",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "CELERINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-564-4545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A45547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A45570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINICA MEDINA MEDICAL OFFICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Gate, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; 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.