Active NPI
Sam Basta
- Attendant Care Provider
- Los Angeles, CA
National Provider Identifier
1174092506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Attendant Care Provider
- Practice address
- 3757 Kelton Ave Apt 211
Los Angeles, CA 90034-7135 - Phone
- (310) 465-6019
- NPI assigned
- Nov 14, 2018
- Last updated
- Nov 14, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | Primary |
Addresses
Primary practice location
3757 Kelton Ave Apt 211
Los Angeles, CA 90034-7135
Mailing address
3757 Kelton Ave Apt 211
Los Angeles, CA 90034-7135
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 473411858 | Medicaid | CA |
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": "1542153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542153600000",
"number": "1174092506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3757 KELTON AVE APT 211",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900347135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3757 KELTON AVE APT 211",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900347135",
"telephone_number": "310-465-6019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASTA",
"first_name": "SAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-14",
"last_updated": "2018-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "473411858",
"state": "CA"
}
],
"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 14, 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.