Robert Tracy DO, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ROBERT TRACY DO, INC

Practice address

3056 Fletcher Dr
Los Angeles, CA 90065-2207

Phone

(323) 256-2231

Fax

(323) 892-2571

NPI assigned

Feb 6, 2015

Organization subpart

No

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

Authorized official

Name

Robert A Tracy, D.O.NPI 1316219058

Title

Owner

Phone

(323) 256-2231

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

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

• Robert A Tracy, DO

  • Adult Medicine Physician
  • Los Angeles, CA
  • NPI 1316219058
  Medicare reassignment NPD Authorized official
• Ron Alexander Birnbaum, M.D,

  • Dermatology Physician
  • Torrance, CA
  • NPI 1942412291
  Medicare reassignment NPD
• Martha G Morris, PA-C

  • Medical Physician Assistant
  • Los Angeles, CA
  • NPI 1578800827
  Medicare reassignment

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

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725408000000",
    "number": "1083005474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3056 FLETCHER DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900652207",
            "telephone_number": "323-256-2231",
            "fax_number": "323-892-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3056 FLETCHER DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900652207",
            "telephone_number": "323-256-2231",
            "fax_number": "323-892-2571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "292 N Wilshire Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928015851",
            "country_code": "US",
            "telephone_number": "714-215-4555",
            "fax_number": "213-800-8335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROBERT TRACY DO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-06",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A",
        "authorized_official_last_name": "TRACY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-256-2231",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.