Individual provider Active NPI

Laila I Muderspach, M.D.

  • Gynecologic Oncology Physician
  • Los Angeles, CA
National Provider Identifier
1306841648
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
G57989 Issued in CA
Practice address
1516 San Pablo St
Los Angeles, CA 90033-5313
Phone
(323) 276-3705
NPI assigned
Jun 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X G57989 CA
Gynecologic Oncology Physician 207VX0201X G57989 CA Primary

Addresses

Primary practice location

1516 San Pablo St
Los Angeles, CA 90033-5313

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 276-3705

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address laila.muderspach@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

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
I20070621000196 CA Practitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 9739288457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological OncologyAlso: Obstetrics/Gynecology
Education
Loma Linda University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444

1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

625 S Fair Oaks Ave
Pasadena, CA 91105-2684
Phone (626) 683-9000

Hospital & facility affiliations

  • Usc Kenneth Norris Jr Cancer Hospital Hospital, Los Angeles, CA, CCN 050660
  • Keck Hospital of Usc Hospital, Los Angeles, CA, CCN 050696
  • Los Angeles General Medical Center Hospital, Los Angeles, CA, CCN 050373

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G57989CAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Apr 1, 2009 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Apr 1, 2009 Accepting new patients
Usc Obstetricians and Gynecologists, Inc. Gynecology PastSince Jul 1, 2007 Accepting new patients

Locations

1441 Eastlake Ave
Ste 7417
Los Angeles, CA 90089
Phone (213) 764-3922

1516 San Pablo St
Los Angeles, CA 90033
Phone (323) 276-3705

1640 Marengo St
Ste 505
Los Angeles, CA 90033

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

1500 San Pablo St
Los Angeles, CA 90033
Phone (323) 443-8500

625 S Fair Oaks Ave
Ste 400
Pasadena, CA 91105
Phone (626) 568-1622

800 Fairmount Ave
Ste 220
Pasadena, CA 91105
Phone (323) 221-3270

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1306841648",
    "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": "323-276-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 SAN PABLO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-276-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDERSPACH",
        "first_name": "LAILA",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-14",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "G57989",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "CA",
            "license": "G57989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "laila.muderspach@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1516 San Pablo St",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.