Charlie Sam Nephrology

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

CHARLIE SAM NEPHROLOGY

Practice address

505 S Virgil Ave Ste 301
Los Angeles, CA 90020-1443

Phone

(213) 674-8282

Fax

(213) 232-7013

NPI assigned

Oct 24, 2014

Last updated

Oct 24, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles Cho, M.D.NPI 1053512566

Title

President

Phone

(213) 674-8282

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Cho, M.D.

  • Nephrology Physician
  • Los Angeles, CA
  • NPI 1053512566
  Medicare reassignment NPD Authorized official
• Jungwoo Kim

  • Family Nurse Practitioner
  • Los Angeles, CA
  • NPI 1184439465
  NPD
• Wonju Park, NP

  • Family Nurse Practitioner
  • Los Angeles, CA
  • NPI 1871397778
  NPD
• Yuna Lee

  • Family Nurse Practitioner
  • Los Angeles, CA
  • NPI 1326680281
  NPD (past)

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1184029712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S. VIRGIL AVE.",
            "address_2": "SUITE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90020",
            "telephone_number": "213-674-8282",
            "fax_number": "213-232-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S VIRGIL AVE STE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201443",
            "telephone_number": "213-674-8282",
            "fax_number": "213-232-7013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLIE SAM NEPHROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "CHO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-674-8282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reneice Johntine Charles, MSW
• Robert David Charles Jr.
• David F Charlet, P.T.
• Charley Lang, MFT
• Erica A Charley
• Cary Charlin, DDS
• Anita Ann Charlot
• Charlotte Haigh Marriage and Family Therapy, Inc. (Knownfully Holistic Therapy)
• Casey Leonard Charlton, MD
• Frank Charlton, DPT

• Primary Care Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.