Organization Active NPI

Newborn Special Care Medical Group

  • Neonatal-Perinatal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1104066570
Registry record updated Feb 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
Legal business name
NEWBORN SPECIAL CARE MEDICAL GROUP
Practice address
1720 E Cesar E Chavez Ave
Los Angeles, CA 90033-2414
Phone
(323) 268-5000
NPI assigned
Feb 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2009

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

Authorized official

Name
Sumithra Kommareddy
Title
Principal Officer/Director/Owner
Phone
(949) 492-3514

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080N0001X Primary

Addresses

Primary practice location

1720 E Cesar E Chavez Ave
Los Angeles, CA 90033-2414

Mailing address

PO Box 1359
San Clemente, CA 92674-1359
Phone (949) 492-3514

Other identifiers 1

IdentifierTypeStateIssuer
1761090OtherCASECRETARY OF STATE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235520000000",
    "number": "1104066570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1359",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926741359",
            "telephone_number": "949-492-3514",
            "fax_number": "949-366-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 E CESAR E CHAVEZ AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332414",
            "telephone_number": "323-268-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWBORN SPECIAL CARE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-25",
        "last_updated": "2009-02-25",
        "status": "A",
        "authorized_official_last_name": "KOMMAREDDY",
        "authorized_official_first_name": "SUMITHRA",
        "authorized_official_title_or_position": "PRINCIPAL OFFICER/DIRECTOR/OWNER",
        "authorized_official_telephone_number": "949-492-3514"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECRETARY OF STATE",
            "identifier": "1761090",
            "state": "CA"
        }
    ],
    "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 25, 2009; 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.