Organization Active NPI

Liva Yates Gritton, M.D., Inc.

  • Physical Medicine & Rehabilitation Physician
  • Pasadena, CA
National Provider Identifier
1073632402
Registry record updated Aug 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
G76396 Issued in CA
Legal business name
LIVA YATES GRITTON, M.D., INC.
Practice address
960 E Green St Ste 254
Pasadena, CA 91106-2418
Phone
(626) 304-9060
Fax
(626) 304-9010
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2010

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

Authorized official

Name
Liva Yates Gritton, M.D.NPI 1528184033
Title
President
Phone
(626) 304-9060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X G76396 CA Primary

Addresses

Primary practice location

960 E Green St Ste 254
Pasadena, CA 91106-2418

Mailing address

P.O. Box 80998
San Marino, CA 91118-8998
Phone (626) 304-9060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041023000268 CA Part B Supplier - Clinic/Group Practice 6204897184 Receives reassigned benefits from 1 practitioner
Practice locations: Arcadia, CA; Van Nuys, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283126400000",
    "number": "1073632402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 80998",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911188998",
            "telephone_number": "626-304-9060",
            "fax_number": "626-304-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 E GREEN ST STE 254",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062418",
            "telephone_number": "626-304-9060",
            "fax_number": "626-304-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVA YATES GRITTON, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2010-08-30",
        "status": "A",
        "authorized_official_last_name": "GRITTON",
        "authorized_official_first_name": "LIVA",
        "authorized_official_middle_name": "YATES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-304-9060",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "G76396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; 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.

Verify at the official NPI Registry.