Individual provider Active NPI

Gloria Slavinski

  • Physician Assistant
  • South Gate, CA
National Provider Identifier
1407422645
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA64858 Issued in CA
Practice address
4476 Tweedy Blvd
South Gate, CA 90280-6359
Phone
(323) 268-9191
NPI assigned
May 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA64858 CA Primary

Addresses

Primary practice location

4476 Tweedy Blvd
South Gate, CA 90280-6359

Mailing address

4476 Tweedy Blvd Ste B
South Gate, CA 90280-6359

Other identifiers 1

IdentifierTypeStateIssuer
98825476F90191MedicaidCA

Other names 1

  • Gloria Choi Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250214002069 CA Practitioner - Physician Assistant 0042740342 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
64858CAMDDentist
PA64858CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Via Care Community Health Center CurrentSince Dec 9, 2024 Accepting new patients

Locations

501 S Atlantic Blvd
Los Angeles, CA 90022
Phone (323) 268-5442

507 S Atlantic Blvd
Los Angeles, CA 90022
Phone 32326891911067

4476 Tweedy Blvd
Ste B
South Gate, CA 90280
Phone (323) 825-8300

4476 Tweedy Blvd
South Gate, CA 90280
Phone (323) 563-9499

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": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1407422645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4476 TWEEDY BLVD STE B",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4476 TWEEDY BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806359",
            "telephone_number": "323-268-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLAVINSKI",
        "first_name": "GLORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-28",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98825476F90191",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "CHOI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Gate, CA

Sources for this page

Verify at the official NPI Registry.