Organization Active NPI

Rillie Medical Group

  • Adult Mental Health Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1093305260
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
RILLIE MEDICAL GROUP
Practice address
1221 N Orange Dr
Ste 317
Los Angeles, CA 90038
Phone
(310) 896-5183
NPI assigned
Jan 21, 2021
Last updated
Jan 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Authorized official

Name
Dan Shultz
Title
Employee
Phone
(310) 896-5183

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Addiction Medicine (Internal Medicine) Physician 207RA0401X

Addresses

Primary practice location

1221 N Orange Dr
Ste 317
Los Angeles, CA 90038

Mailing address

1221 N Orange Dr
Ste 317
Los Angeles, CA 90038
Phone (310) 896-5183

Other identifiers 1

IdentifierTypeStateIssuer
C50677OtherCALIFORNIA MEDICAL LICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1093305260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 N ORANGE DR",
            "address_2": "STE 317",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90038",
            "telephone_number": "310-896-5183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 N ORANGE DR",
            "address_2": "STE 317",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90038",
            "telephone_number": "310-896-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RILLIE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "SHULTZ",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "EMPLOYEE",
        "authorized_official_telephone_number": "310-896-5183"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA MEDICAL LICENSE",
            "identifier": "C50677",
            "state": null
        }
    ],
    "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 Jan 21, 2021; 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.