Active NPI
Jagan N. Bansal, M.D., Inc.
- Family Medicine Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- JAGAN N. BANSAL, M.D., INC.
- Practice address
- 443 S Soto St
Los Angeles, CA 90033-4315 - Phone
- (323) 263-6103
- Fax
- (323) 263-2004
- NPI assigned
- Oct 19, 2006
- Last updated
- Sep 15, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jagan Nath Bansal, M.D.
- Title
- Ceo
- Phone
- (323) 478-1101
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NU | Primary |
Addresses
Primary practice location
443 S Soto St
Los Angeles, CA 90033-4315
Mailing address
5540 N Figueroa St
Los Angeles, CA 90042-4120
Phone (323) 478-1101
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0100470 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
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NPIs listed together on one Medicare enrollment, typically parts of the same organization.
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National Provider Directory
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1316044800000",
"number": "1013099936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5540 N FIGUEROA ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900424120",
"telephone_number": "323-478-1101",
"fax_number": "323-255-2745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "443 S SOTO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900334315",
"telephone_number": "323-263-6103",
"fax_number": "323-263-2004"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JAGAN N. BANSAL, M.D., INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-19",
"last_updated": "2011-09-15",
"status": "A",
"authorized_official_last_name": "BANSAL",
"authorized_official_first_name": "JAGAN",
"authorized_official_middle_name": "NATH",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "323-478-1101",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0100470",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.