Active NPI
Phillip Medina
- Day Training/Habilitation Specialist
- Los Angeles, CA
National Provider Identifier
1366166647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Day Training/Habilitation Specialist
- Practice address
- 510 S Vermont Ave
Los Angeles, CA 90020-1992 - Phone
- (213) 760-2333
- NPI assigned
- Sep 29, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Day Training/Habilitation Specialist | 373H00000X | Primary |
Addresses
Primary practice location
510 S Vermont Ave
Los Angeles, CA 90020-1992
Mailing address
510 S Vermont Ave
Los Angeles, CA 90020-1912
Phone (800) 854-7771
Other practice location 1
840 N Avenue 66
Los Angeles, CA 90042
Phone (626) 395-7100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746748800000",
"number": "1366166647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 S VERMONT AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900201912",
"telephone_number": "800-854-7771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 S VERMONT AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900201992",
"telephone_number": "213-760-2333"
}
],
"practiceLocations": [
{
"address_1": "840 N Avenue 66",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "90042",
"country_code": "US",
"telephone_number": "626-395-7100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEDINA",
"first_name": "PHILLIP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-29",
"last_updated": "2025-05-09",
"certification_date": "2025-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "373H00000X",
"taxonomy_group": "",
"desc": "Day Training/Habilitation Specialist",
"state": null,
"license": null,
"primary": true
}
],
"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 May 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.