Individual provider Active NPI

Sandra Chu Damiani, MD

  • Family Medicine Physician
  • Harbor City, CA
National Provider Identifier
1073661955
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G85489 Issued in CA
Practice address
1403 Lomita Blvd Ste 103
Harbor City, CA 90710-2084
Phone
(310) 784-1800
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G85489 CA Primary

Addresses

Primary practice location

1403 Lomita Blvd Ste 103
Harbor City, CA 90710-2084

Mailing address

2550 West Main St
Suite 301
Alhambra, CA 91801-7003
Phone (626) 457-6900

Other practice location 1

1403 Lomita Blvd Ste 100
Harbor City, CA 90710-2084
Phone (310) 784-5800

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

LicenseStateTypeSpecialty
G85489CAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1073661955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 WEST MAIN ST",
            "address_2": "SUITE 301",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918017003",
            "telephone_number": "626-457-6900",
            "fax_number": "626-457-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 LOMITA BLVD STE 103",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907102084",
            "telephone_number": "310-784-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1403 Lomita Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Harbor City",
            "state": "CA",
            "postal_code": "907102084",
            "country_code": "US",
            "telephone_number": "310-784-5800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHU DAMIANI",
        "first_name": "SANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G85489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harbor City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.