Active NPI
Corbett Lee Penton, M.D.
- Anesthesiology Physician
- Long Beach, CA
National Provider Identifier
1982624425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G21858
- Practice address
- 2801 Atlantic Ave
Long Beach, CA 90806-1701 - Phone
- (562) 933-2000
- Fax
- (562) 933-1245
- NPI assigned
- Jul 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G21858 | CA | Primary |
Addresses
Primary practice location
2801 Atlantic Ave
Long Beach, CA 90806-1701
Mailing address
PO Box 10429
Newport Beach, CA 92658-0429
Phone (949) 417-1812
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G218580385 | Other | CA | CALOPTIMA ID # |
| 00G218580 | Medicaid | CA | |
| 00G218580 | Other | CA | BLUE SHIELD ID # |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G21858 | CA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| California Anesthesia Associates Medical Group, Inc. | Anesthesiology | Past | Accepting new patients |
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.
-
- Anesthesiology Physician
- Long Beach, CA
- NPI 1457399933
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1982624425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10429",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926580429",
"telephone_number": "949-417-1812",
"fax_number": "949-417-1803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 ATLANTIC AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908061701",
"telephone_number": "562-933-2000",
"fax_number": "562-933-1245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENTON",
"first_name": "CORBETT",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G21858",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALOPTIMA ID #",
"identifier": "00G218580385",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G218580",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD ID #",
"identifier": "00G218580",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.