Westside Multi-Specialty Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

FNP34645 Issued in CA

Legal business name

WESTSIDE MULTI-SPECIALTY MEDICAL GROUP, INC.

Practice address

6200 Wilshire Blvd
Suite 1212
Los Angeles, CA 90048-5801

Phone

(323) 933-7200

NPI assigned

Jul 25, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Sousanna Lachtchouk, NPNPI 1982654844

Title

Officer

Phone

(323) 933-7200

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Sousanna Lachtchouk, NP

  • Nurse Practitioner
  • Los Angeles, CA
  • NPI 1982654844
  NPD (past) Authorized official
• Marvin James Lopez Barruga, CRNA

  • Certified Registered Nurse Anesthetist
  • Monterey Park, CA
  • NPI 1548345143
  NPD (past)

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216944000000",
    "number": "1083879324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD",
            "address_2": "SUITE 1212",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485801",
            "telephone_number": "323-933-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD",
            "address_2": "SUITE 1212",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485801",
            "telephone_number": "323-933-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE MULTI-SPECIALTY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-25",
        "last_updated": "2008-07-25",
        "status": "A",
        "authorized_official_last_name": "LACHTCHOUK",
        "authorized_official_first_name": "SOUSANNA",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "323-933-7200",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "FNP34645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Westside Hospice Comfortcare Incorporation
• Westside Hospice,Inc.
• Westside Innovative School House, Inc.
• Westside Medical Center Inc
• Westside Medical Pharmacy Corp
• Westside Multispecialty Surgery Center, LP
• Westside Neurotherapeutics Inc
• Westside Neurotherapeutics, LLC.
• Westside Occupational Therapy Inc
• Westside Pediatrics, Inc.

• 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 Jul 25, 2008; 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.