Medardo C. Supnet, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A46203 Issued in CA

Practice address

3585 E. Imperial Hwy.
Lynwood, CA 90262-2654

Phone

(310) 605-4260

Fax

(310) 605-4263

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (4 of 5)

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Medardo C. Supnet, M.D., Inc

  • Specialist
  • Lynwood, CA
  • NPI 1699923235
  NPD (past) Authorized official
• Medardo Supnet M.D. Inc

  • Legal Medicine
  • Lynwood, CA
  • NPI 1003089970
  NPD (past)
• Pih Health Downey Hospital

  • General Acute Care Hospital
  • Downey, CA
  • NPI 1265433551
  NPD (past)
• St Francis Medical Center

  • Long Term Care Hospital
  • Lynwood, CA
  • NPI 1346378270
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1992817860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3585 E. IMPERIAL HWY.",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622654",
            "telephone_number": "310-605-4260",
            "fax_number": "310-605-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3585 E. IMPERIAL HWY.",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622654",
            "telephone_number": "310-605-4260",
            "fax_number": "310-605-4263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14359 Pioneer Blvd Ste C",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CA",
            "postal_code": "906504850",
            "country_code": "US",
            "telephone_number": "562-406-8605",
            "fax_number": "562-406-8614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUPNET",
        "first_name": "MEDARDO",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A46203",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A46203",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stuart Wolf MD PC
• Daniel Suales
• Jenae Suite
• Billie Jo Summers
• Malik Summers
• Prashanth Sutrave, MD
• Sylvia J Shaw MD a Medical Corp
• Albert K Szeto, MD
• Ashley Szmania, NP
• T K Peterson MD

• All providers in Lynwood, CA
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; 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.