Individual provider Active NPI

Amanda Dale McCann, MD

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1326621632
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A193452 Issued in CA
Practice address
200 UCLA Medical PLZ Ste 265
Los Angeles, CA 90095-6062
Phone
(310) 825-0867
Fax
(310) 794-5066
NPI assigned
May 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A193452 CA Primary

Addresses

Primary practice location

200 UCLA Medical PLZ Ste 265
Los Angeles, CA 90095-6062

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-5138

Other practice location 1

4650 W Sunset Blvd # 68
Los Angeles, CA 90027-6062
Phone (323) 361-4709

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
I20240726003910 CA Practitioner - HospitalistPractitioner - Pediatric Medicine 9234675117 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A193452CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Pediatrics CurrentSince Sep 1, 2024 Accepting new patients
UCLA Medical Group Pediatrics Past Accepting new patients

Locations

200 UCLA Medical Plz
Ste 265
Los Angeles, CA 90095
Phone (310) 206-2429

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

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

10833 Le Conte Ave
#12311
Los Angeles, CA 90095
Phone (310) 825-9124

892 Aerovista Pl
Ste 210
San Luis Obispo, CA 93401
Phone (805) 549-8023

1260 15th St
Ste 1024
Santa Monica, CA 90404
Phone (424) 259-8570

215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435

Organizations & group practices 2

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": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1326621632",
    "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": "310-301-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLZ STE 265",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900956062",
            "telephone_number": "310-825-0867",
            "fax_number": "310-794-5066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4650 W Sunset Blvd # 68",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900276062",
            "country_code": "US",
            "telephone_number": "323-361-4709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCANN",
        "first_name": "AMANDA",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A193452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.