Individual provider Active NPI

Payal Kenia Gu, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Los Angeles, CA
National Provider Identifier
1033555453
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
A155723 Issued in CA
Practice address
4650 W Sunset Blvd # 83
Los Angeles, CA 90027-6062
Phone
(323) 361-2101
NPI assigned
May 13, 2013
Last updated
Jun 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301102609 MI
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X A155723 CA Primary

Addresses

Primary practice location

4650 W Sunset Blvd # 83
Los Angeles, CA 90027-6062

Mailing address

4650 W Sunset Blvd # 83
Los Angeles, CA 90027-6062
Phone (323) 361-2101

Other practice location 1

450 Broadway St Fl C2
Redwood City, CA 94063-3132
Phone (650) 723-6601

Other practice location 2

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone (734) 763-5589

Other names 1

  • Dr. Payal Kenia Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190917000287 CA Practitioner - Pediatric Medicine 5799092862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Medical College of Georgia School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Hospital Los Angeles Medical Group IncGroup PAC ID 0143126920, 288 clinicians

Practice addresses (Care Compare)

4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone (323) 361-8408

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A155723CAMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Aug 29, 2019 Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients
Children's Hospital Los Angeles Past Accepting new patients
Childrens Hospital Medical Practice Corporation Pediatrics Past Accepting new patients

Locations

3701 Wilshire Blvd
Ste 600
Los Angeles, CA 90010
Phone (323) 361-3550

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

4650 W Sunset Blvd
#83
Los Angeles, CA 90027
Phone (323) 361-2101

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1033555453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD # 83",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD # 83",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-2101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Broadway St Fl C2",
            "address_purpose": "LOCATION",
            "city": "Redwood City",
            "state": "CA",
            "postal_code": "940633132",
            "country_code": "US",
            "telephone_number": "650-723-6601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 E Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095000",
            "country_code": "US",
            "telephone_number": "734-763-5589",
            "fax_number": "734-763-4208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GU",
        "first_name": "PAYAL",
        "middle_name": "KENIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-13",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301102609",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CA",
            "license": "A155723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAYAL",
            "last_name": "KENIA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.