Individual provider Active NPI

Talia Kolin, M.D.

  • Ophthalmology Physician
  • Los Angeles, CA
National Provider Identifier
1285720680
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G64713 Issued in CA
Practice address
4036 Whittier Blvd
Suite 202
Los Angeles, CA 90023-2560
Phone
(323) 262-3333
Fax
(323) 262-3333
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G64713 CA Primary

Addresses

Primary practice location

4036 Whittier Blvd
Suite 202
Los Angeles, CA 90023-2560

Mailing address

10842 Portofino PL
Los Angeles, CA 90077-2301
Phone (323) 262-3333

Other identifiers 1

IdentifierTypeStateIssuer
00G647131MedicaidCA

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
I20040416001083 CA Practitioner - Ophthalmology 0042205395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Icahn School of Medicine at Mount Sinai, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Hospital Los Angeles Medical Group IncGroup PAC ID 0143126920, 288 clinicians

Practice addresses (Care Compare)

4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone (323) 361-8408

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G64713CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Los Angeles Medical Group, Inc. CurrentSince Nov 17, 2017 Accepting new patients
Children'S Hospital Los Angeles Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients
White Memorial Medical Center Past Accepting new patients
Marcos Lemor, MD a Medical Corporation Ophthalmology PastSince Aug 10, 2016 Accepting new patients
Eladh, LP Past Accepting new patients

Locations

4650 W Sunset Blvd
#88
Los Angeles, CA 90027
Phone (323) 361-2344

4650 W Sunset Blvd
Ste 88
Los Angeles, CA 90027

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1285720680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10842 PORTOFINO PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900772301",
            "telephone_number": "323-262-3333",
            "fax_number": "323-262-3528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4036 WHITTIER BLVD",
            "address_2": "SUITE 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900232560",
            "telephone_number": "323-262-3333",
            "fax_number": "323-262-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLIN",
        "first_name": "TALIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G64713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G647131",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.