NPIMap

Organization Active NPI

Usc Caruso Department, Otolaryngology-Head and Neck Surgery

  • Otolaryngology Physician
  • Los Angeles, CA
National Provider Identifier
1235501636
Registry record updated Oct 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A138856 Issued in CA
Legal business name
USC CARUSO DEPARTMENT, OTOLARYNGOLOGY-HEAD AND NECK SURGERY
Practice address
1983 Marengo St
Los Angeles, CA 90033-1370
Phone
(323) 409-5070
NPI assigned
Oct 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2015

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

Authorized official

Name
Caitlin Bertelsen, M.D.
Title
Resident Physician
Phone
(323) 226-7315

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X A138856 CA Primary

Addresses

Primary practice location

1983 Marengo St
Los Angeles, CA 90033-1370

Mailing address

1540 Alcazar St
Suite 204M
Los Angeles, CA 90089-0080

National Provider Directory

National Provider Directory
Tax ID family
Usc Caruso Department Otolaryngology-Head and Neck Surgery612 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1540 Alcazar St
Ste 204M
Los Angeles, CA 90089
Phone (323) 442-4830

NPI Registry JSON

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

{
    "created_epoch": "1445644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445644800000",
    "number": "1235501636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 ALCAZAR ST",
            "address_2": "SUITE 204M",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900890080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1983 MARENGO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331370",
            "telephone_number": "323-409-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USC CARUSO DEPARTMENT, OTOLARYNGOLOGY-HEAD AND NECK SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-24",
        "last_updated": "2015-10-24",
        "status": "A",
        "authorized_official_last_name": "BERTELSEN",
        "authorized_official_first_name": "CAITLIN",
        "authorized_official_title_or_position": "RESIDENT PHYSICIAN",
        "authorized_official_telephone_number": "323-226-7315",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A138856",
            "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 Oct 24, 2015; 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.