Organization Active NPI

Westwood Medical Group,Inc.

  • Rheumatology Physician
  • Los Angeles, CA
National Provider Identifier
1124104427
Registry record updated May 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
A78556 Issued in CA
Legal business name
WESTWOOD MEDICAL GROUP,INC.
Practice address
505 S Virgil Ave
Suite 208
Los Angeles, CA 90020-1415
Phone
(213) 739-0007
Fax
(213) 739-0011
NPI assigned
Oct 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2014

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

Authorized official

Name
Sonwoo Lee, MDNPI 1336168616
Title
Medical Director
Phone
(213) 739-0007

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X A78554 CA
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X A78556 CA Primary

Addresses

Primary practice location

505 S Virgil Ave
Suite 208
Los Angeles, CA 90020-1415

Mailing address

505 S Virgil Ave
Suite 208
Los Angeles, CA 90020-1415
Phone (213) 739-0007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070612000510 CA Part B Supplier - Clinic/Group Practice 6305944596 Receives reassigned benefits from 3 practitioners
Practice locations: Los Angeles, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1067350Westwood Medical Group505 S Virgil Ave Ste 208, Los Angeles, CA 90020Certificate of waiverApr 16, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400544000000",
    "number": "1124104427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S VIRGIL AVE",
            "address_2": "SUITE 208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201415",
            "telephone_number": "213-739-0007",
            "fax_number": "213-739-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S VIRGIL AVE",
            "address_2": "SUITE 208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201415",
            "telephone_number": "213-739-0007",
            "fax_number": "213-739-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTWOOD MEDICAL GROUP,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-29",
        "last_updated": "2014-05-20",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "SONWOO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "213-739-0007",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A78554",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "A78556",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.