Carly Genevieve Chiwiwi

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

885 Tiverton Dr
Los Angeles, CA 90095-0001

Phone

(310) 825-6373

NPI assigned

Feb 21, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Carly Nicole Garcia Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Contra Costa County

  • Adult Mental Health Clinic/Center
  • San Pablo, CA
  • NPI 1376620336
  Medicare reassignment NPD
• Contra Costa County

  • General Acute Care Hospital
  • Martinez, CA
  • NPI 1386719086
  NPD

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1275231979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 TIVERTON DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-825-6373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 TIVERTON DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-825-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIWIWI",
        "first_name": "CARLY",
        "middle_name": "GENEVIEVE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "GARCIA",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heather Anne Chiurazzi, DDS
• Brian C Chiusano
• Donna M Chivaroli, NP
• Daniel J Chivas
• Srinivas Chivukula, M.D.
• Chla Usc-Ucedd Nutrition
• Chlamg-Pathology LP
• Chloe Berro, Licensed Clinical Social Worker, Inc.
• Hikmat Chmait, MD, MS
• Waldemar Chmielewski, DDS

• Student in an Organized Health Care Education/Training Program in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.