Organization Active NPI

Id Med a Medical Corporation

  • Specialist
  • Torrance, CA
National Provider Identifier
1982635637
Registry record updated Apr 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ID MED A MEDICAL CORPORATION
Practice address
23430 Hawthorne Blvd Ste 200
Torrance, CA 90505-4730
Phone
(310) 784-5880
Fax
(310) 325-3117
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2018

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

Authorized official

Name
Dr. James C Ding, M.D.NPI 1285614636
Title
President
Phone
(310) 784-5880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

23430 Hawthorne Blvd Ste 200
Torrance, CA 90505-4730

Mailing address

23430 Hawthorne Blvd Ste 200
Torrance, CA 90505-4730
Phone (310) 784-5880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050614001475 CA Part B Supplier - Clinic/Group Practice 2365486966 Receives reassigned benefits from 9 practitioners
Practice locations: Torrance, CA

National Provider Directory

National Provider Directory
Tax ID family
HCP Ipa - South Bay2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522972800000",
    "number": "1982635637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23430 HAWTHORNE BLVD STE 200",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054730",
            "telephone_number": "310-784-5880",
            "fax_number": "310-325-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23430 HAWTHORNE BLVD STE 200",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054730",
            "telephone_number": "310-784-5880",
            "fax_number": "310-325-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ID MED A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2018-04-06",
        "status": "A",
        "authorized_official_last_name": "DING",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-784-5880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.