NPIMap

Organization Active NPI

Ralph Potkin MD a Medical Corp

  • Medical Specialty Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1215079751
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
RALPH POTKIN MD A MEDICAL CORP
Practice address
1125 S Beverly Dr
Suite 406
Los Angeles, CA 90035-1148
Phone
(310) 551-1178
Fax
(310) 551-2047
NPI assigned
Feb 13, 2007
Last updated
Nov 22, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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

Authorized official

Name
Ralph T Potkin, MDNPI 1710043096
Title
President
Phone
(310) 551-1178

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

1125 S Beverly Dr
Suite 406
Los Angeles, CA 90035-1148

Mailing address

1125 S Beverly Dr
Suite 406
Los Angeles, CA 90035-1148
Phone (310) 551-1178

National Provider Directory

National Provider Directory

Locations

1125 S Beverly Dr
Ste 406
Los Angeles, CA 90035
Phone (310) 551-1178

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385078400000",
    "number": "1215079751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 S BEVERLY DR",
            "address_2": "SUITE 406",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351148",
            "telephone_number": "310-551-1178",
            "fax_number": "310-551-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 S BEVERLY DR",
            "address_2": "SUITE 406",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351148",
            "telephone_number": "310-551-1178",
            "fax_number": "310-551-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALPH POTKIN MD A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2013-11-22",
        "status": "A",
        "authorized_official_last_name": "POTKIN",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-551-1178",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "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 Nov 22, 2013; 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.