Active NPI
Newborn Special Care Medical Group
- Neonatal-Perinatal Medicine Physician
- Los Angeles, CA
National Provider Identifier
1104066570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1761090 | Other | CA | SECRETARY OF STATE |
National Provider Directory
National Provider DirectoryNPI 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.