One provider matched this enrollment ID.
Enrollment ID O20121012000596 resolves to a single NPI record. Open the full profile for complete detail.
Medicare enrollment
This provider holds a Medicare enrollment on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.
Part B Supplier
- O20121012000596Clinic/Group PracticeCA
Source: CMS PECOS public enrollment file.
Secondary identifiers
Additional identifiers this provider has registered with NPPES. Used by medical billers, credentialers, and insurance verifiers to cross-reference claims and enrollments.
Other
- C3423023CA· Issued by SECRETARY OF STATE CORPORATION NUMBER
- CLR00343337CA· Issued by CA CLINICAL LAB REGISTRATION
- ZZZ70684YCA· Issued by BLUE SHIELD OF CALIFORNIA GROUP PROVIDER NUMBER
- 43221CA· Issued by CA MEDICAL BOARD- FICTITIOUS NAME PERMIT
- BU21223680CA· Issued by CITY OF LONG BEACH BUSINESS LICENSE
- 05D2048806CA· Issued by CLIA WAIVED CERTIFICATE
Source: NPPES public registry.
ReferenceAbout Medicare Enrollment IDs
A Medicare Enrollment ID (ENRLMT_ID) is a 15-character public identifier assigned by the CMS Provider Enrollment, Chain and Ownership System (PECOS) when a provider, supplier, or organisation enrols in Medicare. Each row reflects one enrolment record: a single NPI can hold multiple enrolments across provider types, states, or supplier categories. Data here is mirrored from the quarterly public PECOS enrolment file published on data.cms.gov.