Active NPI
Regina Pally, M.D.
- Prescribing (Medical) Psychologist
- Los Angeles, CA
National Provider Identifier
1053531400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prescribing (Medical) Psychologist
- License
- G28298
- Practice address
- 11980 San Vicente Blvd
Suite 810
Los Angeles, CA 90049-5012 - Phone
- (310) 820-2700
- NPI assigned
- Apr 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prescribing (Medical) Psychologist | 103TP0016X | G28298 | CA | Primary |
Addresses
Primary practice location
11980 San Vicente Blvd
Suite 810
Los Angeles, CA 90049-5012
Mailing address
11980 San Vicente Blvd
Suite 810
Los Angeles, CA 90049-5012
Phone (310) 820-2700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G28298 | Other | CA | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G28298 | CA | MD | Prescribing (Medical) Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053531400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11980 SAN VICENTE BLVD",
"address_2": "SUITE 810",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900495012",
"telephone_number": "310-820-2700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11980 SAN VICENTE BLVD",
"address_2": "SUITE 810",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900495012",
"telephone_number": "310-820-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALLY",
"first_name": "REGINA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TP0016X",
"taxonomy_group": "",
"desc": "Psychologist, Prescribing (Medical)",
"state": "CA",
"license": "G28298",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "G28298",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.