Active NPI
Charles Lewis Kimelman, MD
- Obstetrics & Gynecology Physician
- Tarzana, CA
National Provider Identifier
1295836039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- G24368
- Practice address
- 5525 Etiwanda Ave
Suite 315
Tarzana, CA 91356 - Phone
- (818) 881-9117
- Fax
- (818) 881-0714
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | G24368 | CA | Primary |
Addresses
Primary practice location
5525 Etiwanda Ave
Suite 315
Tarzana, CA 91356
Mailing address
5525 Etiwanda Ave
Suite 315
Tarzana, CA 91356
Phone (818) 881-9117
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2483018 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G24368 | CA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Westwind Womens Services Medical Group | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Health Service Clinic/Center
- West Hills, CA
- NPI 1700935178
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295836039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5525 ETIWANDA AVE",
"address_2": "SUITE 315",
"city": "TARZANA",
"state": "CA",
"postal_code": "91356",
"telephone_number": "818-881-9117",
"fax_number": "818-881-0714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5525 ETIWANDA AVE",
"address_2": "SUITE 315",
"city": "TARZANA",
"state": "CA",
"postal_code": "91356",
"telephone_number": "818-881-9117",
"fax_number": "818-881-0714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMELMAN",
"first_name": "CHARLES",
"middle_name": "LEWIS",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "CA",
"license": "G24368",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2483018",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tarzana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.