John Thornton Lundgren, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A23459 Issued in CA

Practice address

9777 Wilshire Blvd.
Suite 905
Beverly Hills, CA 90212

Phone

(310) 273-7495

Fax

(310) 273-0714

NPI assigned

Nov 25, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 20, 2016 through Apr 20, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259107200000",
    "number": "1033447305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9777 WILSHIRE BLVD.",
            "address_2": "SUITE 905",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90212",
            "telephone_number": "310-273-7495",
            "fax_number": "310-273-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9777 WILSHIRE BLVD.",
            "address_2": "SUITE 905",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90212",
            "telephone_number": "310-273-7495",
            "fax_number": "310-273-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDGREN",
        "first_name": "JOHN",
        "middle_name": "THORNTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-25",
        "last_updated": "2009-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A23459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Anne Luethge Stern, PA-C, MPAS
• Luis Vallejo, M.D., Inc.
• Kristen Lum Green, LAC
• Jill Lummus, PSYD
• Karla Francesca Lumunsad, FNP
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• Jessica Rose Lutz
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• Lyle D. Kurtz, M.D., Inc.
• Stacy Ann Lyons, PMHNP-BC, LPC

• Psychiatry Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.