NPIMap

Organization Active NPI

Children's Hospital Los Angeles Medical Group

  • Ophthalmology Physician
  • Los Angeles, CA
National Provider Identifier
1073798716
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CHILDREN'S HOSPITAL LOS ANGELES MEDICAL GROUP
Practice address
4650 W Sunset Blvd # 88
Los Angeles, CA 90027-6062
Phone
(323) 361-2344
NPI assigned
Dec 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
James Lin
Title
Chief Financial Officer
Phone
(323) 361-2345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

4650 W Sunset Blvd # 88
Los Angeles, CA 90027-6062

Mailing address

3250 Wilshire Blvd Ste 1101
Los Angeles, CA 90010-1513

Other identifiers 1

IdentifierTypeStateIssuer
GR006667HMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
University Childrens Me37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Locations

4650 W Sunset Blvd
#88
Los Angeles, CA 90027
Phone (323) 361-2344

NPI Registry JSON

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1073798716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 WILSHIRE BLVD STE 1101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD # 88",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HOSPITAL LOS ANGELES MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-31",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "LIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "323-361-2345"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR006667H",
            "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 Mar 27, 2024; 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.