Individual provider Active NPI

Jonathan Ghiam, D.O.

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1336516277
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A16421 Issued in CA
Practice address
1401 S Grand Ave
Los Angeles, CA 90015
Phone
(772) 398-7936
NPI assigned
Aug 26, 2015
Last updated
Jul 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A16421 CA Primary

Addresses

Primary practice location

1401 S Grand Ave
Los Angeles, CA 90015

Mailing address

10501 Wilshire Blvd Unit 1411
Los Angeles, CA 90024-6314
Phone (213) 748-2411

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
I20190509002892 CA Practitioner - Family Practice 3173866308 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hospitalist Group of Montebello IncGroup PAC ID 2264715143, 55 clinicians

Practice addresses (Care Compare)

1701 Santa Anita Ave
S El Monte, CA 91733-3411
Phone (626) 579-7777

9777 Wilshire Blvd
Suite 400
Beverly Hills, CA 90212-1910
Phone (310) 362-1144

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A16421CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Im-FSR Inc. Single Specialty CurrentSince Jun 1, 2025 Accepting new patients
Hospitalist Group of Montebello Inc Single Specialty CurrentSince Feb 1, 2019 Accepting new patients
Calorie Clinic Medical Corporation Single Specialty CurrentSince Jul 24, 2025 Accepting new patients

Locations

9777 Wilshire Blvd
Ste 400
Beverly Hills, CA 90212
Phone (310) 362-1144

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

2701 S Bristol St
Santa Ana, CA 92704
Phone (714) 636-0342

1701 Santa Anita Ave
South El Monte, CA 91733
Phone (626) 350-7916

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1336516277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10501 WILSHIRE BLVD UNIT 1411",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900246314",
            "telephone_number": "213-748-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S GRAND AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90015",
            "telephone_number": "772-398-7936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHIAM",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-26",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A16421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.