Interactive Healthcare Medical Group PC

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

Last updated

Apr 16, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael S Broukhim, MDNPI 1609064880

Title

President

Phone

(310) 441-2000

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Broukhim, M.D.

  • Interventional Cardiology Physician
  • Santa Monica, CA
  • NPI 1609064880
  Authorized official Same address or phone

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": []
}

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• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Medicine Physician in California

• 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.