NPIMap

Individual provider Active NPI

Lucia Loredana Dattoma, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Simi Valley, CA
National Provider Identifier
1164628384
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
A87809 Issued in CA
Practice address
2655 1St St Ste 360
Simi Valley, CA 93065-1581
Phone
(805) 583-7640
Fax
(805) 583-7641
NPI assigned
Jun 25, 2007
Last updated
Aug 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X A87809 CA Primary

Addresses

Primary practice location

2655 1St St Ste 360
Simi Valley, CA 93065-1581

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070831000394 CA Practitioner - Geriatric MedicinePractitioner - Internal Medicine 5193818490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Medical Plaza
Los Angeles, CA 90095-0001

100 Medical PLZ
Suite 310
Los Angeles, CA 90095-0001
Phone (310) 825-7922

141 Triunfo Canyon Rd
Westlake Village, CA 91361-2525
Phone (805) 371-1393

19950 Rinaldi St
Porter Ranch, CA 91326-4141

200 Medical Plaza
Los Angeles, CA 90095-0001

200 Medical PLZ
Los Angeles, CA 90095-0001

200 UCLA Medical PLZ
Suite 165 34
Los Angeles, CA 90095-0001
Phone (310) 824-8403

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381

900 Weyburn Place
Suite 14 171
Los Angeles, CA 90095-0001
Phone (310) 825-8173

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Geriatric Medicine CurrentSince Jul 1, 2007 Accepting new patients
The Regents of the University of California CurrentSince Jul 1, 2007 Accepting new patients
UCLA Medical Group Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
The Regents of the University of California Past Accepting new patients

Locations

5767 W Century Blvd
#400
Los Angeles, CA 90045

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 55737
Los Angeles, CA 90074

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

2655 1st St
Ste 360
Simi Valley, CA 93065
Phone (805) 583-7640

Interoperability endpoints

  • Direct secure messaging: ldattoma150840@direct.uclahealth.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mary Health of the Sick Convalescent and Nursing Hospital IncorporatedNewbury Park, CA, CCN 055022 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 2023
Jun 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1164628384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 1ST ST STE 360",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651581",
            "telephone_number": "805-583-7640",
            "fax_number": "805-583-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATTOMA",
        "first_name": "LUCIA",
        "middle_name": "LOREDANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A87809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.