Eddie D Colbert

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CAS #4866 Issued in CA

Practice address

11905 S Central Ave
Suite 205
Los Angeles, CA 90059-2836

Phone

(323) 249-9026

Fax

(323) 249-8367

NPI assigned

Apr 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bernie'S Lil Women Center Inc

  • Substance Abuse Rehabilitation Facility
  • Los Angeles, CA
  • NPI 1891810560
  NPD (past)

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205959244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5414 KNOXVILLE AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907131736",
            "telephone_number": "310-850-0640",
            "fax_number": "323-249-8367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11905 S CENTRAL AVE",
            "address_2": "SUITE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900592836",
            "telephone_number": "323-249-9026",
            "fax_number": "323-249-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBERT",
        "first_name": "EDDIE",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CAS #4866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Colantonio, MD
• Erin Colantuono, NP
• Latonia Colas
• Colbert Acupuncture
• Alton Colbert Jr., RAS
• Kimberly Colbert
• Kimberly Gizelle Colbert, LCSW
• Maria Annette Colbert, LVN
• Ramona G Colbert, LAC.
• Thomas Colbert

• Addiction (Substance Use Disorder) Counselor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.