Organization Active NPI

Galaxy Medical Center Inc

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1245425073
Registry record updated Sep 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A54904 Issued in CA
Legal business name
GALAXY MEDICAL CENTER INC
Practice address
6221 Wilshire Blvd
Suite #401
Los Angeles, CA 90048-5201
Phone
(323) 655-3747
Fax
(323) 932-0133
NPI assigned
Sep 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2007

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

Authorized official

Name
Dr. Gennady Musher, M.D., PH.D.NPI 1730210352
Title
President
Phone
(323) 655-3747

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X A54904 CA Primary

Addresses

Primary practice location

6221 Wilshire Blvd
Suite #401
Los Angeles, CA 90048-5201

Mailing address

6221 Wilshire Blvd
Suite #401
Los Angeles, CA 90048-5201
Phone (323) 655-3747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040721000940 CA Part B Supplier - Clinic/Group Practice 8022098045 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory
Tax ID family
Galaxy Medical Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6221 Wilshire Blvd
Ste 401
Los Angeles, CA 90048
Phone (323) 555-3747

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189728000000",
    "number": "1245425073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6221 WILSHIRE BLVD",
            "address_2": "SUITE #401",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485201",
            "telephone_number": "323-655-3747",
            "fax_number": "323-932-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 WILSHIRE BLVD",
            "address_2": "SUITE #401",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485201",
            "telephone_number": "323-655-3747",
            "fax_number": "323-932-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALAXY MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-14",
        "last_updated": "2007-09-14",
        "status": "A",
        "authorized_official_last_name": "MUSHER",
        "authorized_official_first_name": "GENNADY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-655-3747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., PH.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A54904",
            "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 Sep 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.