Active NPI
Children'S Hospital Los Angeles Medical Group
- Pediatric Dentistry
- Los Angeles, CA
National Provider Identifier
1235337882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- Legal business name
- CHILDREN'S HOSPITAL LOS ANGELES MEDICAL GROUP
- Practice address
- 4650 W Sunset Blvd
Ms# 116
Los Angeles, CA 90027-6062 - Phone
- (323) 361-4131
- NPI assigned
- Jul 5, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- James Lin
- Title
- Chief Financial Officer
- Phone
- (323) 361-1601
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | Primary |
Addresses
Primary practice location
4650 W Sunset Blvd
Ms# 116
Los Angeles, CA 90027-6062
Mailing address
3250 Wilshire Blvd Ste 1101
Los Angeles, CA 90010-1513
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G90877-01 | Medicaid | CA |
National Provider Directory
National Provider Directory- Tax ID family
- Children'S Hospital Los Angeles Medical Group
Other organizations with this tax ID 36
Organizations that report the same tax identification number in the National Provider Directory.
-
- Plastic Surgery Physician
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-
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-
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-
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-
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-
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-
- Pediatric Surgery Physician
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-
- Pediatric Emergency Medicine (Emergency Medicine) Physician
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-
- Pediatric Adolescent Medicine Physician
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-
- Pediatric Rehabilitation Medicine Physician
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-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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-
- Pediatric Infectious Diseases Physician
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Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatric Dentistry
- Los Angeles, CA
- NPI 1609281443
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183593600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1719792000000",
"number": "1235337882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3250 WILSHIRE BLVD STE 1101",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900101513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4650 W SUNSET BLVD",
"address_2": "MS# 116",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900276062",
"telephone_number": "323-361-4131"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHILDREN'S HOSPITAL LOS ANGELES MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2007-07-05",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A",
"authorized_official_last_name": "LIN",
"authorized_official_first_name": "JAMES",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "323-361-1601"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G90877-01",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
- Children'S Hospital Los Angeles Medical Group
- Children'S Hospital Los Angeles Medical Group
- Children'S Hospital Los Angeles Medical Group
- Children'S Hospital Los Angeles Medical Group
- Children'S Hospital Los Angeles Medical Group
- Children'S Hospital Los Angeles Medical Group
- Children'S Hospital Los Angeles Medical Group
- Children'S Hospital Los Angeles Medical Group
- Children'S Hospital Los Angeles Medical Group
- Children'S Hospital Los Angeles Medical Group
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.