Organization Active NPI

Prestige Broadway Medical Center Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Los Angeles, CA
National Provider Identifier
1134075203
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
PRESTIGE BROADWAY MEDICAL CENTER INC
Practice address
2926 N Broadway
Los Angeles, CA 90031-2601
Phone
(213) 433-3137
Fax
(213) 433-3136
NPI assigned
Mar 10, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Authorized official

Name
Maneesh Singhal, MDNPI 1700017068
Title
Ceo/Owner
Phone
(213) 433-3137

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X Primary

Addresses

Primary practice location

2926 N Broadway
Los Angeles, CA 90031-2601

Mailing address

2926 N Broadway
Los Angeles, CA 90031-2601
Phone (213) 433-3137

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260417002516 CA Part B Supplier - Clinic/Group Practice 7618443516 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

2926 N Broadway
Los Angeles, CA 90031
Phone (213) 221-1131

Practitioners & affiliated clinicians

Practitioners 1

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": "1773100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773100800000",
    "number": "1134075203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2926 N BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312601",
            "telephone_number": "213-433-3137",
            "fax_number": "213-433-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2926 N BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312601",
            "telephone_number": "213-433-3137",
            "fax_number": "213-433-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE BROADWAY MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-10",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A",
        "authorized_official_last_name": "SINGHAL",
        "authorized_official_first_name": "MANEESH",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "213-433-3137",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "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 Mar 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.