Organization Active NPI

Children's Hospital Los Angeles Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1265530653
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CHILDREN'S HOSPITAL LOS ANGELES MEDICAL GROUP, INC.
Practice address
4650 Sunset Blvd
Los Angeles, CA 90027
Phone
(323) 361-2337
Fax
(323) 361-8491
NPI assigned
Sep 20, 2006
Last updated
Apr 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Authorized official

Name
Kitty Wan
Title
Chief Financial Officer
Phone
(323) 361-1601

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

4650 Sunset Blvd
Los Angeles, CA 90027

Mailing address

3250 Wilshire Blvd Ste 1101
Los Angeles, CA 90010-1513
Phone (323) 361-2337

Other identifiers 19

IdentifierTypeStateIssuer
GR0066671OtherCAMEDICAID & CALOPTIMA GROU
GR0066677OtherCAMEDICAID AND CALOPTIMA GR
GR0066676OtherCAMEDICAID AND CALOPTIMA GR
GR006667COtherCAMEDICAID AND CALOPTIMA GR
GR0066670OtherCAMEDICAID AND CALOPTIMA GR
GR0066675OtherCAMEDICAID AND CALOPTIMA GR
GR0066673OtherCAMEDICAID AND CALOPTIMA GR
GR006667EOtherCAMEDICAID AND CALOPTIMA GR
GR006667GOtherCAMEDICAID AND CALOPTIMA GR
GR0066672OtherCAMEDICAID & CALOPTIMA GROU
GR0066674OtherCAMEDICAID AND CALOPTIMA GR
GR006667DOtherCAMEDICAID AND CALOPTIMA GR
GR006667FOtherCAMEDICAID AND CALOPTIMA GR
GR0066675MedicaidCA
GR0066678OtherCAMEDICAID AND CALOPTIMA GR
GR0066679OtherCAMEDICAID AND CALOPTIMA GR
GR006667BOtherCAMEDICAID AND CALOPTIMA GR
G9087701OtherCAMEDICAID AND CALOPTIMA GR
GR006667AOtherCAMEDICAID AND CALOPTIMA GR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031211000522 CA Part B Supplier - Clinic/Group Practice 0143126920 Receives reassigned benefits from 1,291 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1,357

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 1,357

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775606400000",
    "number": "1265530653",
    "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",
            "telephone_number": "323-361-2337",
            "fax_number": "323-361-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90027",
            "telephone_number": "323-361-2337",
            "fax_number": "323-361-8491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HOSPITAL LOS ANGELES MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A",
        "authorized_official_last_name": "WAN",
        "authorized_official_first_name": "KITTY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "323-361-1601"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID & CALOPTIMA GROU",
            "identifier": "GR0066671",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND CALOPTIMA GR",
            "identifier": "GR0066677",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND CALOPTIMA GR",
            "identifier": "GR0066676",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND CALOPTIMA GR",
            "identifier": "GR006667C",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND CALOPTIMA GR",
            "identifier": "GR0066670",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND CALOPTIMA GR",
            "identifier": "GR0066675",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND CALOPTIMA GR",
            "identifier": "GR0066673",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND CALOPTIMA GR",
            "identifier": "GR006667E",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND CALOPTIMA GR",
            "identifier": "GR006667G",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID & CALOPTIMA GROU",
            "identifier": "GR0066672",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND CALOPTIMA GR",
            "identifier": "GR0066674",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND CALOPTIMA GR",
            "identifier": "GR006667D",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND CALOPTIMA GR",
            "identifier": "GR006667F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0066675",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND CALOPTIMA GR",
            "identifier": "GR0066678",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND CALOPTIMA GR",
            "identifier": "GR0066679",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND CALOPTIMA GR",
            "identifier": "GR006667B",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND CALOPTIMA GR",
            "identifier": "G9087701",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND CALOPTIMA GR",
            "identifier": "GR006667A",
            "state": "CA"
        }
    ],
    "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 Apr 8, 2026; 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.