Individual provider Active NPI

Mary Ann P Limbos, MD, MPH

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1164517108
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G77419 Issued in CA
Practice address
4650 W Sunset Blvd
Ms# 76
Los Angeles, CA 90027-6062
Phone
(323) 669-2534
Fax
(323) 906-8003
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 G77419 CA Primary

Addresses

Primary practice location

4650 W Sunset Blvd
Ms# 76
Los Angeles, CA 90027-6062

Mailing address

6430 W Sunset Blvd
Suite 600
Los Angeles, CA 90028-7901
Phone (323) 669-2337

Other identifiers 1

IdentifierTypeStateIssuer
00G774190MedicaidCA

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
I20091214000013 CA Practitioner - Pediatric Medicine 8224178876 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ole Health CurrentSince Aug 9, 2024 Accepting new patients
Ole Health Current Accepting new patients
Ole Health CurrentSince Aug 9, 2024 Accepting new patients
Ole Health Past Accepting new patients

Locations

2051 John Jones Rd
Davis, CA 95616
Phone (530) 753-3498

1141 Pear Tree Ln
Ste 100
Napa, CA 94558
Phone (707) 254-1778

1141 Pear Tree Ln
Napa, CA 94558
Phone (707) 258-6128

215 W Beamer St
Woodland, CA 95695
Phone (530) 405-2800

Interoperability endpoints

  • Direct secure messaging: mlimbos709965@direct.ochin.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164517108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6430 W SUNSET BLVD",
            "address_2": "SUITE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287901",
            "telephone_number": "323-669-2337",
            "fax_number": "323-644-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "address_2": "MS# 76",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-669-2534",
            "fax_number": "323-906-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIMBOS",
        "first_name": "MARY ANN",
        "middle_name": "P",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G77419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G774190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.