Individual provider Active NPI

Channa Obeyesekere

  • Neonatal/Pediatric Registered Respiratory Therapist
  • Los Angeles, CA
National Provider Identifier
1053837872
Registry record updated Aug 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal/Pediatric Registered Respiratory TherapistTaxonomy code 2279P3900X
License
17385 Issued in CA
Practice address
2051 Marengo St
Los Angeles, CA 90033-1352
Phone
(323) 409-3281
NPI assigned
Aug 15, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal/Pediatric Registered Respiratory Therapist 2279P3900X 17385 CA Primary

Addresses

Primary practice location

2051 Marengo St
Los Angeles, CA 90033-1352

Mailing address

2051 Marengo St
Los Angeles, CA 90033-1352

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502755200000",
    "number": "1053837872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 MARENGO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 MARENGO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331352",
            "telephone_number": "323-409-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBEYESEKERE",
        "first_name": "CHANNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-15",
        "last_updated": "2017-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2279P3900X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Neonatal/Pediatrics",
            "state": "CA",
            "license": "17385",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.