Active NPI
Suzanne Mary Eckhardt, C.P.
- Prosthetist
- Los Angeles, CA
National Provider Identifier
1316134802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetist
- License
- CP001228
- Practice address
- 637 Lucas Ave
Los Angeles, CA 90017-1912 - Phone
- (213) 482-5226
- Fax
- (213) 482-5040
- NPI assigned
- Sep 27, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Prosthetist | 224P00000X | CP001228 | DE | Primary |
Addresses
Primary practice location
637 Lucas Ave
Los Angeles, CA 90017-1912
Mailing address
637 Lucas Ave
Los Angeles, CA 90017-1912
Phone (213) 482-5226
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GFC000250 | 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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP001228 | DE | MD | Prosthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190851200000",
"number": "1316134802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "637 LUCAS AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900171912",
"telephone_number": "213-482-5226",
"fax_number": "213-482-5040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "637 LUCAS AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900171912",
"telephone_number": "213-482-5226",
"fax_number": "213-482-5040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECKHARDT",
"first_name": "SUZANNE",
"middle_name": "MARY",
"credential": "C.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-27",
"last_updated": "2007-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": "DE",
"license": "CP001228",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GFC000250",
"state": "CA"
}
],
"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 Sep 27, 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.