NPIMap

Organization Active NPI

Columbia Medical Group, Inc.

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1336365576
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G36895 Issued in CA
Legal business name
COLUMBIA MEDICAL GROUP, INC.
Practice address
1211 N Vermont Ave
Suite 205
Los Angeles, CA 90029-1748
Phone
(323) 664-4114
Fax
(323) 664-4144
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Authorized official

Name
Hovik Simityan
Title
Office Manager
Phone
(323) 664-4114

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X G36895 CA Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X G36895 CA

Addresses

Primary practice location

1211 N Vermont Ave
Suite 205
Los Angeles, CA 90029-1748

Mailing address

1211 N Vermont Ave
Suite 205
Los Angeles, CA 90029-1748
Phone (323) 664-4114

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1336365576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 N VERMONT AVE",
            "address_2": "SUITE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291748",
            "telephone_number": "323-664-4114",
            "fax_number": "323-664-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 N VERMONT AVE",
            "address_2": "SUITE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291748",
            "telephone_number": "323-664-4114",
            "fax_number": "323-664-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "SIMITYAN",
        "authorized_official_first_name": "HOVIK",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "323-664-4114"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G36895",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "G36895",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.