Active NPI
Glenn Nagami, M.D.
- Nephrology Physician
- Los Angeles, CA
National Provider Identifier
1194835827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- G42710
- Practice address
- 11301 Wilshire Blvd.
Nephrology Mail Code 111L
Los Angeles, CA 90073 - Phone
- (310) 268-3835
- NPI assigned
- Aug 30, 2006
- 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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | G42710 | CA | Primary |
Addresses
Primary practice location
11301 Wilshire Blvd.
Nephrology Mail Code 111L
Los Angeles, CA 90073
Mailing address
11301 Wilshire Blvd.
Nephrology Mail Code 111L
Los Angeles, CA 90073
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130520000294 | CA | Order and Referring Only - Internal Medicine | 8628215282 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G42710 | CA | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194835827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11301 WILSHIRE BLVD.",
"address_2": "NEPHROLOGY MAIL CODE 111L",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11301 WILSHIRE BLVD.",
"address_2": "NEPHROLOGY MAIL CODE 111L",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90073",
"telephone_number": "310-268-3835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAGAMI",
"first_name": "GLENN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "CA",
"license": "G42710",
"primary": true
}
],
"identifiers": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.