NPIMap

Organization Active NPI

The Regents of the University of California

  • Ambulatory Surgical Clinic/Center
  • North Hollywood, CA
National Provider Identifier
1366041469
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
THE REGENTS OF THE UNIVERSITY OF CALIFORNIA
Practice address
4343 Lankershim Blvd Ste 210
North Hollywood, CA 91602-2705
Phone
(818) 843-9038
NPI assigned
Oct 20, 2020
Last updated
Oct 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Authorized official

Name
Brooke Souhrada
Title
Director
Phone
(661) 255-2420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

4343 Lankershim Blvd Ste 210
North Hollywood, CA 91602-2705

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-5256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210205002160 CA Part B Supplier - Ambulatory Surgical Center 1355248584 Receives reassigned benefits from 51 practitioners
Practice locations: North Hollywood, CA

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
The Regents of the University of California Dba UCLA Dept of MedicineCCN 55C0001125
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
UC Regents UCLA Dept Me29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Locations

4343 Lankershim Blvd
#210
North Hollywood, CA 91602

Practitioners & affiliated clinicians

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603152000000",
    "number": "1366041469",
    "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": "310-301-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 LANKERSHIM BLVD STE 210",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916022705",
            "telephone_number": "818-843-9038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE REGENTS OF THE UNIVERSITY OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "SOUHRADA",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "661-255-2420"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.