Unknown Individual – Family Medicine Physician, NPI 1942289616

Unknown Individual is a healthcare provider. based in South gate, California. specializing in Family Medicine Physician. They hold a License No. A39370 (CA). The NPI Number for Unknown Individual is 1942289616

Main info

Organization
Inactive
61 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1942289616
Phone
(323) 564-6464
Address
4225 TWEEDY BLVD
Deactivation Date
8 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1965 (61 years ago)
PAC ID
1759481047
Professional Enrollment ID
I20070716000629
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 4225, Tweedy Boulevard, Tweedy Mile Business District, South Gate, Los Angeles County, California, 90280, United States

    SOUTH GATE, CA 902806217

    Phone: (323) 564-6464

    Fax: (323) 564-8578

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 90280)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1942289616 for Unknown Individual, then check state licensing separately.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights South Gate, California; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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