Individual provider Active NPI

Jordan Alexander David, MD

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1336534833
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A147994 Issued in CA
Practice address
3303 N Broadway
Los Angeles, CA 90031-2803
Phone
(323) 478-8200
NPI assigned
Apr 1, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A147994 CA Primary

Addresses

Primary practice location

3303 N Broadway
Los Angeles, CA 90031-2803

Mailing address

3303 N Broadway
Los Angeles, CA 90031-2803
Phone (323) 478-8200

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
I20200326001331 CA Practitioner - Psychiatry 4385073394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
New York Medical College, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Los Angeles County Department of Mental HealthGroup PAC ID 7416869896, 294 clinicians

Practice addresses (Care Compare)

5321 Via Marisol
Los Angeles, CA 90042-4883
Phone (323) 478-8200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A147994CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Nov 12, 2021 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Nov 12, 2021 Accepting new patients

Locations

550 S Vermont Ave
Fl 6
Los Angeles, CA 90020
Phone (213) 351-7284

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

5321 Via Marisol
Los Angeles, CA 90042
Phone (323) 474-6393

2260 E Palmdale Blvd
Ste J
Palmdale, CA 93550
Phone (661) 575-1800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1336534833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 N BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312803",
            "telephone_number": "323-478-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 N BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312803",
            "telephone_number": "323-478-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVID",
        "first_name": "JORDAN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-01",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A147994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.