Individual provider Active NPI

Kayla Elizabeth Gan, OTR

  • Occupational Therapist
  • Los Angeles, CA
National Provider Identifier
1306509260
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT22959 Issued in CA
Practice address
100 Stein PLZ FL 1
Los Angeles, CA 90095-1061
Phone
(310) 206-9566
NPI assigned
Oct 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Occupational Therapist 225XL0004X 22959 CA
Occupational Therapist 225X00000X OT22959 CA Primary

Addresses

Primary practice location

100 Stein PLZ FL 1
Los Angeles, CA 90095-1061

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707

Other practice location 1

1640 Marengo St Ste 500
Los Angeles, CA 90033-1061
Phone (323) 442-3340

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211109002475 CA Practitioner - Occupational Therapist in Private Practice 0345639548 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jules Stein Eye Institute Medical GroupGroup PAC ID 5597663740, 118 clinicians

Practice addresses (Care Compare)

622 W Duarte Rd
Suite 101
Arcadia, CA 91007-7606
Phone (323) 442-7122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT22959CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Nov 2, 2021 Accepting new patients
Jules Stein Eye Institute Medical Group CurrentSince Jul 1, 2023 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Nov 2, 2021 Accepting new patients
Jules Stein Eye Institute Medical Group CurrentSince Jul 1, 2023 Accepting new patients
UCLA Medical Group Past Accepting new patients

Locations

622 W Duarte Rd
Ste 101
Arcadia, CA 91007
Phone (310) 206-1166

18111 Brookhurst St
Ste 6400
Fountain Vly, CA 92708
Phone (714) 350-7258

100 Stein Plz
Fl 1
Los Angeles, CA 90095
Phone (310) 206-9566

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

1640 Marengo St
Ste 500
Los Angeles, CA 90033
Phone (323) 442-3340

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

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

1640 Marengo St
Los Angeles, CA 90033
Phone (323) 223-4091

Organizations & group practices 5

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": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1306509260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 STEIN PLZ FL 1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951061",
            "telephone_number": "310-206-9566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1640 Marengo St Ste 500",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900331061",
            "country_code": "US",
            "telephone_number": "323-442-3340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAN",
        "first_name": "KAYLA",
        "middle_name": "ELIZABETH",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XL0004X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Low Vision",
            "state": "CA",
            "license": "22959",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT22959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.