Michael Etzel

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A179204 Issued in CA

Practice address

2250 Alcazar St
Ste 2200
Los Angeles, CA 90089-1011

Phone

(323) 409-5555

NPI assigned

Mar 23, 2020

Last updated

Jan 29, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Psychiatry

Education

University of Southern California Keck School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Los Angeles County Department of Mental HealthGroup PAC ID 7416869896, 294 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Los Angeles County Department of Mental Health

  dba GENESIS Countywide Older Adult Program

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1083633929
  Medicare reassignment Care Compare group
• Los Angeles County Department of Mental Health

  dba SA5 HOME South Team

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1043690118
  NPD
• Los Angeles County Department of Mental Health

  dba Arcadia Mental Health Center-Full Service Partnership

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Arcadia, CA
  • NPI 1902676075
  NPD

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1285261107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 ALCAZAR ST STE 220",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900891011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 ALCAZAR ST",
            "address_2": "STE 2200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900891011",
            "telephone_number": "323-409-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETZEL",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A179204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yaakov Nachum Etshalom, EMT-B
• Philip Aaron Ettedgui, PHARMD
• Robert Bruce Ettenger, M.D.
• Jonathan Elias Ettinger, BA
• Kate C Ettinger, MFT TRAINEE
• Jacqueline Euan
• Darlene Marie Eubanks, PT
• Rachael Eubanks, DPT
• Robert Eubanks
• Eugene a Goncharov DDS Inc

• Psychiatry Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.