Organization Active NPI

Lda Medical Corporation

  • Clinic/Center
  • Santa Monica, CA
National Provider Identifier
1174436117
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LDA MEDICAL CORPORATION
Practice address
2632 Wilshire Blvd
Ste 685
Santa Monica, CA 90403
Phone
(310) 424-7013
Fax
(239) 999-1340
NPI assigned
Sep 22, 2026
Last updated
Sep 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Authorized official

Name
Dr. Ali J Enayati, MD, MPH
Title
Medical Director
Phone
(310) 424-7013

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

2632 Wilshire Blvd
Ste 685
Santa Monica, CA 90403

Mailing address

2632 Wilshire Blvd
Ste 685
Santa Monica, CA 90403
Phone (310) 424-7013

Other identifiers 1

IdentifierTypeStateIssuer
A73998OtherCALICENSE

NPI Registry JSON

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

{
    "created_epoch": "1790035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790035200000",
    "number": "1174436117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2632 WILSHIRE BLVD",
            "address_2": "STE 685",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90403",
            "telephone_number": "310-424-7013",
            "fax_number": "239-999-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 WILSHIRE BLVD",
            "address_2": "STE 685",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90403",
            "telephone_number": "310-424-7013",
            "fax_number": "239-999-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LDA MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-22",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A",
        "authorized_official_last_name": "ENAYATI",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-424-7013",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MPH"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A73998",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.