Healthcare Provider Details

I. General information

NPI: 1740233725
Provider Name (Legal Business Name): FAMILY CARE SPECIALISTS MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 WASHINGTON BLVD
MONTEBELLO CA
90640-6123
US

IV. Provider business mailing address

5823 YORK BLVD STE 3
LOS ANGELES CA
90042-2634
US

V. Phone/Fax

Practice location:
  • Phone: 323-728-3955
  • Fax: 323-728-6905
Mailing address:
  • Phone: 323-255-5643
  • Fax: 323-254-2158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AUBYN REDMOND
Title or Position: DIRECTOR MEDICAL GROUP OPERATIONS
Credential:
Phone: 510-607-4115