Individual provider Active NPI

Adrienne Youdim, MD

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1083782973
Registry record updated May 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A86625 Issued in CA
Practice address
8700 Beverly Blvd.
Los Angeles, CA 90048-1865
Phone
(310) 423-8350
Fax
(310) 423-3253
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A86625 CA
Internal Medicine Physician 207R00000X A86625 CA Primary

Addresses

Primary practice location

8700 Beverly Blvd.
Los Angeles, CA 90048-1865

Mailing address

PO Box 512717
Los Angeles, CA 90051-0717
Phone (310) 423-8350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Dec 11, 2019 through Dec 11, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A86625CAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273795200000",
    "number": "1083782973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512717",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900510717",
            "telephone_number": "310-423-8350",
            "fax_number": "310-423-3253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD.",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900481865",
            "telephone_number": "310-423-8350",
            "fax_number": "310-423-3253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUDIM",
        "first_name": "ADRIENNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2010-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A86625",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A86625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.