Active NPI
La Vida Multi-Specialty Medical Group
- Specialist
- Hawthorne, CA
National Provider Identifier
1093860298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 051633
- Legal business name
- LA VIDA MULTI-SPECIALTY MEDICAL GROUP
- Practice address
- 4455 W 117TH St
Hawthorne, CA 90250-2241 - Phone
- (310) 645-0444
- Fax
- (310) 216-7336
- NPI assigned
- Jan 25, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Christopher C Chidi, MD
- Title
- President
- Phone
- (310) 214-8677
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 051633 | CA | Primary |
Addresses
Primary practice location
4455 W 117TH St
Hawthorne, CA 90250-2241
Mailing address
Department No 2834
Los Angeles, CA 90084
Phone (310) 214-8677
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0088191 | Medicaid | CA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1093860298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DEPARTMENT NO 2834",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90084",
"telephone_number": "310-214-8677",
"fax_number": "310-921-1718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4455 W 117TH ST",
"city": "HAWTHORNE",
"state": "CA",
"postal_code": "902502241",
"telephone_number": "310-645-0444",
"fax_number": "310-216-7336"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LA VIDA MULTI-SPECIALTY MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-25",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "CHIDI",
"authorized_official_first_name": "CHRISTOPHER",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "310-214-8677",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "051633",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0088191",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hawthorne, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.