NPIMap

Organization Active NPI

Passport Health Los Angeles

  • Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1275866188
Registry record updated Sep 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PASSPORT HEALTH LOS ANGELES
Practice address
5455 Wilshire Blvd
Suite #1802
Los Angeles, CA 90036-4201
Phone
(323) 297-0700
Fax
(323) 549-9423
NPI assigned
Sep 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2009

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

Authorized official

Name
Miss Rayann Aziz
Title
Executive Director
Phone
(323) 297-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

5455 Wilshire Blvd
Suite #1802
Los Angeles, CA 90036-4201

Mailing address

5455 Wilshire Blvd
Suite #1802
Los Angeles, CA 90036-4201
Phone (323) 297-0700

National Provider Directory

National Provider Directory

Locations

5455 Wilshire Blvd
Ste 1802
Los Angeles, CA 90036
Phone (323) 297-0700

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252454400000",
    "number": "1275866188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 WILSHIRE BLVD",
            "address_2": "SUITE #1802",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364201",
            "telephone_number": "323-297-0700",
            "fax_number": "323-549-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 WILSHIRE BLVD",
            "address_2": "SUITE #1802",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364201",
            "telephone_number": "323-297-0700",
            "fax_number": "323-549-9423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSPORT HEALTH LOS ANGELES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-09",
        "last_updated": "2009-09-09",
        "status": "A",
        "authorized_official_last_name": "AZIZ",
        "authorized_official_first_name": "RAYANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "323-297-0700",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.