NPIMap

Organization Active NPI

L.Wiener C.Ross Medical Corp

  • Sports Medicine (Internal Medicine) Physician
  • Los Angeles, CA
National Provider Identifier
1366543290
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X
License
FNP30417 Issued in CA
Legal business name
L.WIENER C.ROSS MEDICAL CORP
Practice address
11540 Santa Monica BL.
#203
Los Angeles, CA 90025-7905
Phone
(310) 914-7600
NPI assigned
Sep 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Authorized official

Name
Dr. Laurence Wiener, D.C.NPI 1164529426
Title
Ceo
Phone
(310) 428-8065

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0010X FNP30417 CA Primary

Addresses

Primary practice location

11540 Santa Monica BL.
#203
Los Angeles, CA 90025-7905

Mailing address

11540 Santa Monica BL. #203
Los Angeles, CA 90025-7905

Other names 1

  • Pacific West Heath Medical associates inc. Doing business as

National Provider Directory

National Provider Directory

Locations

710 Wilshire Blvd
Ste 314
Santa Monica, CA 90401
Phone (310) 395-7535

Practitioners & affiliated clinicians

Practitioners 7

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": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552953600000",
    "number": "1366543290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11540 SANTA MONICA BL. #203",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11540 SANTA MONICA BL.",
            "address_2": "#203",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257905",
            "telephone_number": "310-914-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L.WIENER C.ROSS MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2019-03-19",
        "status": "A",
        "authorized_official_last_name": "WIENER",
        "authorized_official_first_name": "LAURENCE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-428-8065",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "CA",
            "license": "FNP30417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific West Heath Medical associates inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 19, 2019; 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.