Individual provider Active NPI

Amrit Kaur Dhaliwal

  • Gerontology Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1316435365
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
95020311 Issued in CA
Practice address
127 S San Vicente Blvd # a-6100
Los Angeles, CA 90048-3311
Phone
(310) 423-2077
Fax
(310) 248-8252
NPI assigned
Apr 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704304180 MI
Acute Care Nurse Practitioner 363LA2100X .022608 OH
Gerontology Nurse Practitioner 363LG0600X 95020311 CA Primary

Addresses

Primary practice location

127 S San Vicente Blvd # a-6100
Los Angeles, CA 90048-3311

Mailing address

4140 W 190TH St
Torrance, CA 90504-5513
Phone (310) 423-2077

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220719001166 CA Practitioner - Nurse Practitioner 7012271638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr Kamran Parsa IncGroup PAC ID 4880909308, 22 clinicians

Practice addresses (Care Compare)

1120 W Ave
M4
Palmdale, CA 93551-1432
Phone 6614802377207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
.022608OHMDAcute Care Nurse Practitioner
95020311CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Kamran Parsa Inc CurrentSince Dec 1, 2022 Accepting new patients

Locations

1120 W Avenue M4
Palmdale, CA 93551
Phone (661) 480-2377

38420 5th St W
Ste E
Palmdale, CA 93551
Phone (661) 480-2377

13540 Ventura Blvd
Sherman Oaks, CA 91423
Phone (818) 990-0267

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1316435365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513",
            "telephone_number": "310-423-2077",
            "fax_number": "310-248-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 S SAN VICENTE BLVD # A-6100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900483311",
            "telephone_number": "310-423-2077",
            "fax_number": "310-248-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHALIWAL",
        "first_name": "AMRIT",
        "middle_name": "KAUR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-25",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704304180",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": ".022608",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95020311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.