Organization Active NPI

Hornbuckle, Inc.

  • Specialist
  • Venice, CA
National Provider Identifier
1104867803
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G30731 Issued in CA
Legal business name
HORNBUCKLE, INC.
Practice address
1009 Abbot Kinney Blvd
2ND Floor
Venice, CA 90291-3372
Phone
(310) 558-1530
Fax
(310) 526-7775
NPI assigned
Jun 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. John Scott Hornbuckle I
Title
President, Ceo
Phone
(310) 558-1530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X G30731 CA Primary

Addresses

Primary practice location

1009 Abbot Kinney Blvd
2ND Floor
Venice, CA 90291-3372

Mailing address

1009 Abbot Kinney Blvd
2ND Floor
Venice, CA 90291-3372
Phone (310) 558-1530

Other names 1

  • California Community Diagnostic Imaging Doing business as

National Provider Directory

National Provider Directory

Locations

1009 Abbot Kinney Blvd
#2
Venice, CA 90291
Phone (310) 558-1530

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104867803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 ABBOT KINNEY BLVD",
            "address_2": "2ND FLOOR",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902913372",
            "telephone_number": "310-558-1530",
            "fax_number": "310-526-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 ABBOT KINNEY BLVD",
            "address_2": "2ND FLOOR",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902913372",
            "telephone_number": "310-558-1530",
            "fax_number": "310-526-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HORNBUCKLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HORNBUCKLE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "310-558-1530",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "I"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G30731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "California Community Diagnostic Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Venice, 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.

Verify at the official NPI Registry.