NPIMap

Organization Active NPI

Children'S Hospital Los Angeles

  • Specialty Pharmacy
  • Los Angeles, CA
National Provider Identifier
1306274113
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
License
53922 Issued in CA
Legal business name
CHILDREN'S HOSPITAL LOS ANGELES
Practice address
4650 W Sunset Blvd RM 1503
Los Angeles, CA 90027-6062
Phone
(323) 361-8839
Fax
(323) 361-7135
NPI assigned
Oct 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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

Authorized official

Name
Mr. Max Scott Lieberenz, CPA
Title
Sr.VP/Cfo
Phone
(323) 361-2235

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Specialty Pharmacy 3336S0011X 53922 CA Primary

Addresses

Primary practice location

4650 W Sunset Blvd RM 1503
Los Angeles, CA 90027-6062

Mailing address

4650 W Sunset Blvd RM 1503
Los Angeles, CA 90027-6062
Phone (323) 361-8839

Other identifiers 1

IdentifierTypeStateIssuer
2158723OtherPK

Other names 1

  • Children's Hospital Los Angeles Specialty Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100222000603 CA Part B Supplier - Pharmacy 4183641640 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Los Angeles, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Childrens Hospital Phcy16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

4650 W Sunset Blvd
Rm 1503
Los Angeles, CA 90027
Phone (323) 361-8839

4650 W Sunset Blvd
#26
Los Angeles, CA 90027
Phone (323) 361-2543

NPI Registry JSON

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

{
    "created_epoch": "1381795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634256000000",
    "number": "1306274113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD RM 1503",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-8839",
            "fax_number": "323-361-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD RM 1503",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-8839",
            "fax_number": "323-361-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HOSPITAL LOS ANGELES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-15",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A",
        "authorized_official_last_name": "LIEBERENZ",
        "authorized_official_first_name": "MAX",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "SR.VP/CFO",
        "authorized_official_telephone_number": "323-361-2235",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "CA",
            "license": "53922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2158723",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Hospital Los Angeles Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.