Active NPI
Mirna Dearborn
- Rehabilitation Practitioner
- Culver City, CA
National Provider Identifier
1144347618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- License
- NA
- Practice address
- 9808 Venice Blvd
Culver City, CA 90232-2732 - Phone
- (310) 945-3550
- NPI assigned
- Mar 22, 2007
- Last updated
- Jan 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | NA | ||
| Rehabilitation Practitioner | 225400000X | NA | Primary |
Addresses
Primary practice location
9808 Venice Blvd
Culver City, CA 90232-2732
Mailing address
9808 Venice Blvd
Culver City, CA 90232-2732
Phone (310) 945-3550
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515456000000",
"number": "1144347618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9808 VENICE BLVD",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902322732",
"telephone_number": "310-945-3550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9808 VENICE BLVD",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902322732",
"telephone_number": "310-945-3550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEARBORN",
"first_name": "MIRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2018-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": "NA",
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": "NA",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.