Individual provider Active NPI

Susan Rider Harlan, MD, MPH

  • Diagnostic Radiology Physician
  • Los Angeles, CA
National Provider Identifier
1306093158
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A109961 Issued in CA
Practice address
1500 San Pablo St FL 2
Los Angeles, CA 90033
Phone
(323) 442-8541
Fax
(323) 442-8755
NPI assigned
Aug 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A109961 CA Primary

Addresses

Primary practice location

1500 San Pablo St FL 2
Los Angeles, CA 90033

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-8541

Other practice location 1

4650 W Sunset Blvd
Ms 81
Los Angeles, CA 90027-6062
Phone (323) 361-7845

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
I20101228000096 CA Practitioner - Diagnostic RadiologyPractitioner - Other (Physician) 0143418699 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A109961CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc Diagnostic Radiology CurrentSince Feb 6, 2018 Accepting new patients
Children'S Hospital Los Angeles Medical Group, Inc. CurrentSince Mar 17, 2016 Accepting new patients
Glendora Radiological Assoc Inc Diagnostic Radiology CurrentSince May 25, 2019 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Feb 6, 2018 Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients
Children'S Hospital Los Angeles Past Accepting new patients
Keck Medical Center of Usc Past Accepting new patients

Locations

210 W San Bernardino Rd
Covina, CA 91723
Phone (626) 858-8580

250 S Grand Ave
Glendora, CA 91741
Phone (626) 857-3118

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

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

1500 San Pablo St
Fl 2
Los Angeles, CA 90033
Phone (323) 442-8541

4650 W Sunset Blvd
#81
Los Angeles, CA 90027
Phone (323) 361-3033

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

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": "1219449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1306093158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-8541",
            "fax_number": "323-442-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SAN PABLO ST FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90033",
            "telephone_number": "323-442-8541",
            "fax_number": "323-442-8755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4650 W Sunset Blvd",
            "address_2": "MS 81",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900276062",
            "country_code": "US",
            "telephone_number": "323-361-7845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARLAN",
        "first_name": "SUSAN",
        "middle_name": "RIDER",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-23",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A109961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.