Individual provider Active NPI

Johnny T Li, M.D.

  • Orthopaedic Surgery Physician
  • West Hills, CA
National Provider Identifier
1124004965
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A025311 Issued in CA
Practice address
7345 Medical Center Dr
Suite #280
West Hills, CA 91307-1937
Phone
(818) 888-2855
Fax
(818) 888-0702
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A025311 CA Primary

Addresses

Primary practice location

7345 Medical Center Dr
Suite #280
West Hills, CA 91307-1937

Mailing address

7345 Medical Center Dr
Suite #280
West Hills, CA 91307-1937
Phone (818) 888-2855

Other identifiers 4

IdentifierTypeStateIssuer
00A253110MedicaidCA
Y5394OtherCAMEDICARE SUPPLIER #
A025311OtherCACA MEDICAL LICENSE
953718732OtherCACORPORATE TAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1124004965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7345 MEDICAL CENTER DR",
            "address_2": "SUITE #280",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913071937",
            "telephone_number": "818-888-2855",
            "fax_number": "818-888-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7345 MEDICAL CENTER DR",
            "address_2": "SUITE #280",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913071937",
            "telephone_number": "818-888-2855",
            "fax_number": "818-888-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "JOHNNY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A025311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A253110",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SUPPLIER #",
            "identifier": "Y5394",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL LICENSE",
            "identifier": "A025311",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATE TAX ID",
            "identifier": "953718732",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.