Individual provider Active NPI

Hollie Etta Sandlin, M.D

  • Emergency Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1255657177
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A120691 Issued in CA
Practice address
924 Westwood Blvd
Suite 300
Los Angeles, CA 90024-2910
Phone
(310) 794-0585
NPI assigned
Apr 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A120691 CA Primary

Addresses

Primary practice location

924 Westwood Blvd
Suite 300
Los Angeles, CA 90024-2910

Mailing address

401 S Barrington Ave Apt 225
Los Angeles, CA 90049-6420
Phone (206) 795-8145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141211001963 WA Practitioner - Emergency Medicine 6800028309 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Washington School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Washington Emergency Physicians PLLCGroup PAC ID 0749514735, 78 clinicians

Practice addresses (Care Compare)

14815 Pacific Ave S
Tacoma, WA 98444-4654
Phone (253) 697-8660

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A120691CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mt. Rainier Emergency Physicians, PLLC Emergency Medicine CurrentSince Dec 1, 2014 Accepting new patients
Regents of the Univ of Ca Emer Med Emergency Medicine PastSince Oct 1, 2018 Accepting new patients

Locations

401 15th Ave SE
Puyallup, WA 98372
Phone (253) 697-1848

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1271376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1255657177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S BARRINGTON AVE APT 225",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496420",
            "telephone_number": "206-795-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 WESTWOOD BLVD",
            "address_2": "SUITE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900242910",
            "telephone_number": "310-794-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDLIN",
        "first_name": "HOLLIE",
        "middle_name": "ETTA",
        "name_prefix": "Mrs.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-16",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A120691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.