Provider Demographics
NPI:1447263926
Name:ARMATO, JOHN P (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:ARMATO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1101 N SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-5948
Mailing Address - Country:US
Mailing Address - Phone:310-545-6627
Mailing Address - Fax:310-545-0352
Practice Address - Street 1:520 N PROSPECT AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-3041
Practice Address - Country:US
Practice Address - Phone:310-374-7655
Practice Address - Fax:310-372-7026
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2021-03-29
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Provider Licenses
StateLicense IDTaxonomies
CAG58926207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0064100Medicaid
CA00G589260Medicaid
CAGR0064100Medicaid
CAA93524Medicare UPIN
CAWG58926EMedicare ID - Type UnspecifiedINDIVIDUAL NUMBER