Active NPI
Walter Ahhaitty
- Community Health Worker
- El Segundo, CA
National Provider Identifier
1225695604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 400 Continental Blvd FL 6
El Segundo, CA 90245-5074 - Phone
- (213) 387-5772
- NPI assigned
- May 21, 2019
- Last updated
- Jun 12, 2019
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | NU | Primary |
Addresses
Primary practice location
400 Continental Blvd FL 6
El Segundo, CA 90245-5074
Mailing address
10175 Slater Ave Ste 150
Fountain Valley, CA 92708-4717
Phone (714) 962-6673
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Indian Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Highland Park, CA
- NPI 1164767141
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560297600000",
"number": "1225695604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10175 SLATER AVE STE 150",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927084717",
"telephone_number": "714-962-6673",
"fax_number": "714-962-6343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 CONTINENTAL BLVD FL 6",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "902455074",
"telephone_number": "213-387-5772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHHAITTY",
"first_name": "WALTER",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-21",
"last_updated": "2019-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Segundo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.