Individual provider Active NPI

Danielle D. Brum Pavan, M.D.

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1386879807
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A106277 Issued in CA
Practice address
5420 N Figueroa St
Los Angeles, CA 90042-4118
Phone
(323) 256-3884
NPI assigned
May 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A106277 CA Primary

Addresses

Primary practice location

5420 N Figueroa St
Los Angeles, CA 90042-4118

Mailing address

2550 W Main St Ste 301
Alhambra, CA 91801-7003
Phone (626) 457-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100615000811 CA Practitioner - Pediatric MedicinePractitioner - Family Practice 8426188541 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
106277CAMDDentist
A106277CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Community Clinic CurrentSince Mar 24, 2010 Accepting new patients
NPI 1689885907 Pediatrics CurrentSince Mar 24, 2010 Accepting new patients
Northeast Community Clinic Pediatrics Current Accepting new patients

Locations

2550 W Main St
Ste 301
Alhambra, CA 91801
Phone (626) 457-6900

5420 N Figueroa St
Los Angeles, CA 90042
Phone (323) 256-3884

1414 S Grand Ave
Ste 380
Los Angeles, CA 90015
Phone (213) 222-1300

8100 Sunland Blvd
Sun Valley, CA 91352
Phone (818) 242-6811

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1386879807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 W MAIN ST STE 301",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918017003",
            "telephone_number": "626-457-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 N FIGUEROA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900424118",
            "telephone_number": "323-256-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUM PAVAN",
        "first_name": "DANIELLE",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-28",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A106277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.