Individual provider Active NPI

Vital Hinojosa, M.D.

  • General Practice Physician
  • Los Angeles, CA
National Provider Identifier
1396874202
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A37463 Issued in CA
Practice address
2010 Wilshire Blvd
2012
Los Angeles, CA 90057-3507
Phone
(213) 989-1535
Fax
(213) 989-1843
NPI assigned
Mar 5, 2007
Last updated
Feb 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A37463 CA Primary

Addresses

Primary practice location

2010 Wilshire Blvd
2012
Los Angeles, CA 90057-3507

Mailing address

2010 Wilshire Blvd
2012
Los Angeles, CA 90057-3507
Phone (213) 989-1535

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
I20040130001096 CA Practitioner - General Practice 9335042837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37463CAMDChiropractor
A37463CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Health Care and Medical Clinic, Inc. CurrentSince Mar 1, 2011 Accepting new patients
San Lucas Medical Clinic, Inc General Practice Past Accepting new patients
Sundaram Family Medical Clinic, Inc. Past Accepting new patients
Sanavida Medical Group, Inc. General Practice Past Accepting new patients

Locations

1500 S Central Ave
Ste 320
Glendale, CA 91204
Phone (818) 396-5670

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391990400000",
    "number": "1396874202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 WILSHIRE BLVD",
            "address_2": "2012",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573507",
            "telephone_number": "213-989-1535",
            "fax_number": "213-989-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 WILSHIRE BLVD",
            "address_2": "2012",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573507",
            "telephone_number": "213-989-1535",
            "fax_number": "213-989-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINOJOSA",
        "first_name": "VITAL",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2014-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A37463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.