MEDARDO C. SUPNET M.D. INC NPI 1699923235

NPI Information

NPI: 1699923235
Provider Name: MEDARDO C. SUPNET, M.D., INC
Classification: Specialist - 174400000X
Entity Type: Organization
Address: 3585 E IMPERIAL HWY
LYNWOOD, CA
ZIP 90262
Phone: (310) 605-4260

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NPI Details

MEDARDO C. SUPNET, M.D., INC is a specialist in Lynwood, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MEDARDO C. SUPNET, M.D., INC NPI is 1699923235. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

3585 E IMPERIAL HWY
LYNWOOD, CA
ZIP 90262-654
Phone: (310) 605-4260
Fax: (310) 605-4263

The provider's authorized official is Medardo C Supnet .
The authorized official title is Owner and has the following contact phone number (310) 605-4260.

The enumeration date for this NPI number is 9/8/2008 and was last updated on 9/8/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		A50125	CALIFORNIA	No
2	363AM0700X	Physician Assistant	Medical	PA16910	CALIFORNIA	No
3	174400000X	Specialist		A46203	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00A462030	OTHER	CALIFORNIA	MEDICAL RENDERING PROVIDER NUMBER
2	00A501250	OTHER	CALIFORNIA	MEDICAL RENDERING PROVIDER NUMBER
3	PA16910	OTHER	CALIFORNIA	PHYSICIAN ASSISTANT PROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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