Individual provider Active NPI

William Charles Wirshing, M.D.

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1265621601
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G50986 Issued in CA
Practice address
1920 Marengo St
Los Angeles, CA 90033
Phone
(323) 276-6400
NPI assigned
Oct 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry Physician 2084P0805X G50986 CA
Psychiatry Physician 2084P0800X G50986 CA Primary

Addresses

Primary practice location

1920 Marengo St
Los Angeles, CA 90033

Mailing address

1390 El Mirador Dr
Pasadena, CA 91103-2724
Phone (310) 413-4200

Other practice location 1

4411 E Kings Canyon Rd
Fresno, CA 93702-3604
Phone (559) 453-1008

Other practice location 2

1920 Marengo St
Los Angeles, CA 90033
Phone (323) 276-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100108000407 CA Practitioner - Psychiatry 5799826079 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G50986CAMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Exodus Recovery Inc Current Accepting new patients
Exodus Recovery Inc CurrentSince Feb 5, 2019 Accepting new patients
Exodus Recovery, Inc. CurrentSince Feb 5, 2019 Accepting new patients

Locations

3828 Hughes Ave
Culver City, CA 90232
Phone (310) 202-4774

9808 Venice Blvd
Ste 700
Culver City, CA 90232
Phone (310) 253-9494

1920 Marengo St
Los Angeles, CA 90033
Phone (323) 223-4462

12021 Wilmington Ave
Fl 2
Los Angeles, CA 90059
Phone (424) 454-5000

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.

NPI Registry JSON

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1265621601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 EL MIRADOR DR",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911032724",
            "telephone_number": "310-413-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 MARENGO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90033",
            "telephone_number": "323-276-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4411 E Kings Canyon Rd",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937023604",
            "country_code": "US",
            "telephone_number": "559-453-1008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1920 Marengo St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90033",
            "country_code": "US",
            "telephone_number": "323-276-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIRSHING",
        "first_name": "WILLIAM",
        "middle_name": "CHARLES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-22",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "CA",
            "license": "G50986",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G50986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.