Organization Active NPI

KPG Astoria, LLC

  • Addiction Medicine (Internal Medicine) Physician
  • West Hollywood, CA
National Provider Identifier
1386009041
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
MD168198 Issued in OR
Legal business name
KPG ASTORIA, LLC
Practice address
9000 W Sunset Blvd Ste 1500
West Hollywood, CA 90069-5815
Phone
(310) 975-1450
NPI assigned
Dec 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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

Authorized official

Name
Darryl Olivier
Title
Chief Operations Officer
Phone
(310) 975-1450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0401X MD168198 OR Primary

Addresses

Primary practice location

9000 W Sunset Blvd Ste 1500
West Hollywood, CA 90069-5815

Mailing address

9000 W Sunset Blvd Ste 1500
West Hollywood, CA 90069-5815

National Provider Directory

National Provider Directory

Locations

9000 W Sunset Blvd
Ste 1500
West Hollywood, CA 90069
Phone (310) 975-1450

NPI Registry JSON

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450828800000",
    "number": "1386009041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W SUNSET BLVD STE 1500",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900695815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W SUNSET BLVD STE 1500",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900695815",
            "telephone_number": "310-975-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KPG ASTORIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-23",
        "last_updated": "2015-12-23",
        "status": "A",
        "authorized_official_last_name": "OLIVIER",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "310-975-1450"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "OR",
            "license": "MD168198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; 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.