David Haim Bolour, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A136515 Issued in CA

Practice address

604 Rose Ave
Venice, CA 90291-2767

Phone

(323) 383-5322

NPI assigned

May 23, 2012

Last updated

May 11, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: dbolour753238@direct.ochin.org
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1073653630
  Medicare reassignment NPD
• Venice Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Venice, CA
  • NPI 1669418513
  Medicare reassignment NPD
• St. Johns Community Health

  • Community Health Clinic/Center
  • Los Angeles, CA
  • NPI 1073363768
  NPD
• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1285874826
  NPD
• Venice Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Culver City, CA
  • NPI 1003842360
  NPD
• Venice Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Venice, CA
  • NPI 1124054564
  NPD
• Venice Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Hawthorne, CA
  • NPI 1518739515
  NPD
• Venice Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Santa Monica, CA
  • NPI 1558397067
  NPD
• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1780376947
  NPD (past)

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1326308495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 ROSE AVE",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912767",
            "telephone_number": "323-383-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 ROSE AVE",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912767",
            "telephone_number": "323-383-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLOUR",
        "first_name": "DAVID",
        "middle_name": "HAIM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-23",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A136515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "david.bolour.p1@direct.venicefamilyclinic.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "david.bolour.p1@direct.venicefamilyclinic.nextgenshare.com",
            "address_1": "604 Rose Ave",
            "city": "Venice",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902912767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Judith Bin-Nun, PHD
• David Walker Black, D.C.
• Meagan Estrella Black, PCD, DONA
• Blanco Interpreting, Inc.
• Daniel Bolander
• Dylan Booth, DDS
• Daniel John Bouchard, RADT
• Orly F Bouskila, MFT
• Rachel Boyer, AMFT
• Jeremiah Bradshaw

• Pediatrics Physician in Venice, CA
• Providers in Venice, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.