NPIMap

Organization Active NPI

Interactive Healthcare Medical Group PC

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1386087633
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A101434 Issued in CA
Legal business name
INTERACTIVE HEALTHCARE MEDICAL GROUP PC
Practice address
1762 Westwood Blvd
300
Los Angeles, CA 90024-5632
Phone
(310) 441-2000
Fax
(310) 441-2020
NPI assigned
Apr 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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

Authorized official

Name
Dr. Michael S Broukhim, MD
Title
President
Phone
(310) 441-2000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X A101434 CA Primary
Multi-Specialty Clinic/Center 261QM1300X A101434 CA

Addresses

Primary practice location

1762 Westwood Blvd
300
Los Angeles, CA 90024-5632

Mailing address

1762 Westwood Blvd
300
Los Angeles, CA 90024-5632
Phone (310) 441-2000

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366070400000",
    "number": "1386087633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1762 WESTWOOD BLVD",
            "address_2": "300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245632",
            "telephone_number": "310-441-2000",
            "fax_number": "310-441-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1762 WESTWOOD BLVD",
            "address_2": "300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245632",
            "telephone_number": "310-441-2000",
            "fax_number": "310-441-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERACTIVE HEALTHCARE MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-16",
        "last_updated": "2013-04-16",
        "status": "A",
        "authorized_official_last_name": "BROUKHIM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-441-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A101434",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": "A101434",
            "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 Apr 16, 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.

Verify at the official NPI Registry.