Individual provider Active NPI

Lynne Lorraine Chambers, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Harbor City, CA
National Provider Identifier
1275686693
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 12232 Issued in CA
Practice address
25965 South Normandie Ave
Pediatrics 2ND Floor
Harbor City, CA 90710
Phone
(310) 257-6183
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 12232 CA Primary

Addresses

Primary practice location

25965 South Normandie Ave
Pediatrics 2ND Floor
Harbor City, CA 90710

Mailing address

1212 Loma Dr
Hermosa Beach, CA 90254-3814
Phone (310) 257-6183

Other names 1

  • Mrs. Lynne Lorraine Williams Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110125000579 CA Practitioner - Physician Assistant 3971782897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

25821 Vermont Ave
Harbor City, CA 90710-3518
Phone (310) 325-5111

25825 Vermont Ave
Harbor City, CA 90710-3518
Phone (310) 325-5111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
12232CAMDNeurology Chiropractor
PA 12232CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Oct 21, 2010 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 21, 2010 Accepting new patients

Locations

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

25965 Normandie Ave
Fl 2
Harbor City, CA 90710
Phone (310) 257-6183

393 E Walnut St
Pasadena, CA 91188
Phone (626) 405-7914

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1275686693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 LOMA DR",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902543814",
            "telephone_number": "310-257-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25965 SOUTH NORMANDIE AVE",
            "address_2": "PEDIATRICS 2ND FLOOR",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "90710",
            "telephone_number": "310-257-6183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "LYNNE",
        "middle_name": "LORRAINE",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 12232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LYNNE",
            "last_name": "WILLIAMS",
            "middle_name": "LORRAINE",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Harbor City, CA

Sources for this page

Verify at the official NPI Registry.