Individual provider Active NPI

Heather Mee Sook Wynne, MD

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1417699588
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A203673 Issued in CA
Practice address
1300 N Mission Rd
Los Angeles, CA 90033-1021
Phone
(323) 409-8255
NPI assigned
Apr 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A203673 CA Primary

Addresses

Primary practice location

1300 N Mission Rd
Los Angeles, CA 90033-1021

Mailing address

1300 N Mission Rd
Los Angeles, CA 90033-1021
Phone (323) 409-8255

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hwynne@dhs.lacounty.gov Direct

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
I20260407003330 CA Practitioner - Family Practice 3779058771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1670 E 120TH St
Los Angeles, CA 90059-3026

Hospital & facility affiliations

  • Los Angeles General Medical Center Hospital, Los Angeles, CA, CCN 050373

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A203673CAMDFamily Medicine Physician

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1649548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1417699588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N MISSION RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331021",
            "telephone_number": "323-409-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N MISSION RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331021",
            "telephone_number": "323-409-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNNE",
        "first_name": "HEATHER",
        "middle_name": "MEE SOOK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-10",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A203673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hwynne@dhs.lacounty.gov",
            "affiliation": "N",
            "endpointDescription": "county work email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1300 N Mission Rd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900331021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.