Active NPI
Lax Physical Medicine, Inc.
- Physical Medicine & Rehabilitation Physician
- Los Angeles, CA
National Provider Identifier
1386084846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- A101415
- Legal business name
- LAX PHYSICAL MEDICINE, INC.
- Practice address
- 9100 S Sepulveda Blvd
Suite 104
Los Angeles, CA 90045-4849 - Phone
- (310) 670-9999
- Fax
- (310) 670-9994
- NPI assigned
- Jun 28, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Shelley McDonald, MD
- Title
- President
- Phone
- (310) 670-9999
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | A101415 | CA | Primary |
Addresses
Primary practice location
9100 S Sepulveda Blvd
Suite 104
Los Angeles, CA 90045-4849
Mailing address
9100 S Sepulveda Blvd
Suite 104
Los Angeles, CA 90045-4849
Phone (310) 670-9999
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Los Angeles, CA
- NPI 1649300476
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372377600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1375401600000",
"number": "1386084846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9100 S SEPULVEDA BLVD",
"address_2": "SUITE 104",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900454849",
"telephone_number": "310-670-9999",
"fax_number": "310-670-9994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9100 S SEPULVEDA BLVD",
"address_2": "SUITE 104",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900454849",
"telephone_number": "310-670-9999",
"fax_number": "310-670-9994"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAX PHYSICAL MEDICINE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2013-06-28",
"last_updated": "2013-08-02",
"status": "A",
"authorized_official_last_name": "MCDONALD",
"authorized_official_first_name": "SHELLEY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "310-670-9999",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": "CA",
"license": "A101415",
"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 Aug 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.