Individual provider Active NPI

Lynwood Slipp

  • Substance Abuse Rehabilitation Facility
  • Los Angeles, CA
National Provider Identifier
1083152409
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Practice address
4445 Burns Ave
Los Angeles, CA 90029-2702
Phone
(323) 664-8940
Fax
(323) 664-1786
NPI assigned
Feb 6, 2017
Last updated
Feb 6, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

4445 Burns Ave
Los Angeles, CA 90029-2702

Mailing address

810 Beacon Ave
Los Angeles, CA 90017-2114
Phone (323) 979-5441

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": "1486339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486339200000",
    "number": "1083152409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 BEACON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900172114",
            "telephone_number": "323-979-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 BURNS AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900292702",
            "telephone_number": "323-664-8940",
            "fax_number": "323-664-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLIPP",
        "first_name": "LYNWOOD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-06",
        "last_updated": "2017-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "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 Feb 6, 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.