NPIMap

Organization Active NPI

Managedmed, Inc.

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1366738676
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 7084 Issued in CA
Legal business name
MANAGEDMED, INC.
Practice address
5455 Wilshire Blvd
Suite 1903
Los Angeles, CA 90036-4201
Phone
(323) 934-3861
NPI assigned
Jun 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Authorized official

Name
Dr. Seth L. Hirsch, PH.D.NPI 1073734844
Title
Psychologist
Phone
(323) 934-3861

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PSY 7084 CA Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PSY 19483 CA
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A65071 CA
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X A18616 CA

Addresses

Primary practice location

5455 Wilshire Blvd
Suite 1903
Los Angeles, CA 90036-4201

Mailing address

5455 Wilshire Blvd
Suite 1903
Los Angeles, CA 90036-4201
Phone (323) 934-3861

National Provider Directory

National Provider Directory
Tax ID family
Managedmed Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

5455 Wilshire Blvd
Ste 1903
Los Angeles, CA 90036
Phone (323) 934-3861

Practitioners & affiliated clinicians

Practitioners 3

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": "1308873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308873600000",
    "number": "1366738676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 WILSHIRE BLVD",
            "address_2": "SUITE 1903",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364201",
            "telephone_number": "323-934-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 WILSHIRE BLVD",
            "address_2": "SUITE 1903",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364201",
            "telephone_number": "323-934-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANAGEDMED, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-24",
        "last_updated": "2011-06-24",
        "status": "A",
        "authorized_official_last_name": "HIRSCH",
        "authorized_official_first_name": "SETH",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "323-934-3861",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 7084",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 19483",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A65071",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A18616",
            "primary": false
        }
    ],
    "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 Jun 24, 2011; 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.