Jonathan Corren MD, Inc

Primary specialty

Clinical & Laboratory Immunology (Allergy & Immunology) PhysicianTaxonomy code 207KI0005X

License

G53016 Issued in CA

Legal business name

JONATHAN CORREN MD, INC

Practice address

10780 Santa Monica Blvd
Suite #280
Los Angeles, CA 90025-4749

Phone

(310) 312-5050

Fax

(310) 575-9292

NPI assigned

Nov 11, 2013

Organization subpart

No

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

Authorized official

Name

Jonathan Corren, MDNPI 1447360086

Title

President

Phone

(310) 312-5050

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jonathan Corren, MD

  • Clinical & Laboratory Immunology (Allergy & Immunology) Physician
  • Los Angeles, CA
  • NPI 1447360086
  Medicare reassignment Care Compare group NPD Authorized official
• Martha Galvan, MD

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1205274040
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384128000000",
    "number": "1386073377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10780 SANTA MONICA BLVD",
            "address_2": "SUITE #280",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254749",
            "telephone_number": "310-312-5050",
            "fax_number": "310-575-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10780 SANTA MONICA BLVD",
            "address_2": "SUITE #280",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254749",
            "telephone_number": "310-312-5050",
            "fax_number": "310-575-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN CORREN MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-11",
        "last_updated": "2013-11-11",
        "status": "A",
        "authorized_official_last_name": "CORREN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-312-5050",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207KI0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology, Clinical & Laboratory Immunology",
            "state": "CA",
            "license": "G53016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical & Laboratory Immunology (Allergy & Immunology) Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical & Laboratory Immunology (Allergy & Immunology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2013; 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.