Individual provider Active NPI

Max Franklin Lebow, M.D.

  • Emergency Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1104868660
Registry record updated Mar 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G49950 Issued in CA
Practice address
9601 S Sepulveda Blvd
Los Angeles, CA 90045-5203
Phone
(310) 419-7058
Fax
(310) 491-7075
NPI assigned
Jun 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G49950 CA Primary

Addresses

Primary practice location

9601 S Sepulveda Blvd
Los Angeles, CA 90045-5203

Mailing address

1140 Laurel Ave
Manhattan Beach, CA 90266-4906
Phone (310) 546-5049

Other identifiers 1

IdentifierTypeStateIssuer
00G499500MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050804000393 CA Practitioner - Emergency MedicinePractitioner - Preventive Medicine 2961430533 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Immediate Care Medical Group, Inc. CurrentSince May 7, 2023 Accepting new patients
Reliant Immediate Care Medical Group, Inc. Emergency Medicine CurrentSince Dec 30, 2002 Accepting new patients
Max Franklin Lebow, a Medical Corporation Emergency Medicine PastSince Jun 18, 2005 Accepting new patients
Centinela Freeman Emergency Medical Associates Emergency Medicine Past Accepting new patients

Locations

9601 S Sepulveda Blvd
Los Angeles, CA 90045
Phone (310) 215-6020

2300 W Beverly Blvd
Ste 100
Montebello, CA 90640
Phone (626) 467-0202

11460 Telegraph Rd
Santa Fe Springs, CA 90670
Phone (562) 864-1000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301270400000",
    "number": "1104868660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 LAUREL AVE",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902664906",
            "telephone_number": "310-546-5049",
            "fax_number": "310-546-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 S SEPULVEDA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455203",
            "telephone_number": "310-419-7058",
            "fax_number": "310-491-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBOW",
        "first_name": "MAX",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2011-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G49950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G499500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.