NPIMap

Organization Active NPI

Kimberly M Nowak DO, a Professional Corp

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1144822602
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
KIMBERLY M NOWAK DO, A PROFESSIONAL CORP
Practice address
2135 Park Dr
Los Angeles, CA 90026-1919
Phone
(714) 318-3017
NPI assigned
Nov 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Authorized official

Name
Kimberly Nowak, DO
Title
Owner
Phone
(714) 318-3017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

2135 Park Dr
Los Angeles, CA 90026-1919

Mailing address

2135 Park Dr
Los Angeles, CA 90026-1919
Phone (714) 318-3017

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604966400000",
    "number": "1144822602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2135 PARK DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900261919",
            "telephone_number": "714-318-3017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2135 PARK DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900261919",
            "telephone_number": "714-318-3017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY M NOWAK DO, A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-10",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A",
        "authorized_official_last_name": "NOWAK",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-318-3017",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "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 Nov 10, 2020; 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.