Individual provider Active NPI

Lwbba Grissell Chait Llamas, M.D.

  • Pediatrics Physician
  • Brawley, CA
National Provider Identifier
1134567530
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A138938 Issued in CA
Practice address
751 W Legion Rd
Suite 103
Brawley, CA 92227-7732
Phone
(760) 351-4100
Fax
(760) 351-4101
NPI assigned
Jun 6, 2013
Last updated
Mar 30, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A138938 CA Primary

Addresses

Primary practice location

751 W Legion Rd
Suite 103
Brawley, CA 92227-7732

Mailing address

PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725

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
I20170328001897 CA Practitioner - Pediatric Medicine 0345525671 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A138938CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Jan 28, 2019 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Jan 28, 2019 Accepting new patients

Locations

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

1601 Precision Park Ln
San Ysidro, CA 92173
Phone (619) 205-4585

4004 Beyer Blvd
San Ysidro, CA 92173
Phone (619) 428-1330

4050 Beyer Blvd
San Ysidro, CA 92173

Interoperability endpoints

  • Direct secure messaging: lchaitllamas18572@syhealth.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490832000000",
    "number": "1134567530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 W LEGION RD",
            "address_2": "SUITE 103",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922277732",
            "telephone_number": "760-351-4100",
            "fax_number": "760-351-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAIT LLAMAS",
        "first_name": "LWBBA",
        "middle_name": "GRISSELL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-06",
        "last_updated": "2017-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A138938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brawley, CA

Sources for this page

Verify at the official NPI Registry.