Individual provider Active NPI

Whitney Paullin, M.D.

  • Pediatrics Physician
  • Redondo Beach, CA
National Provider Identifier
1427412048
Registry record updated Nov 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A157612 Issued in CA
Practice address
1820 S Elena Ave Ste H
Redondo Beach, CA 90277-5700
Phone
(310) 489-3304
Fax
(310) 695-2896
NPI assigned
Apr 9, 2016
Last updated
Nov 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X A157612 CA Primary

Addresses

Primary practice location

1820 S Elena Ave Ste H
Redondo Beach, CA 90277-5700

Mailing address

1820 S Elena Ave Ste H
Redondo Beach, CA 90277-5700

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20191106001423 CA Practitioner - Pediatric Medicine 7911239280 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A157612CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Sep 2, 2019 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 2, 2019 Accepting new patients
Dr. Whitney Single Specialty CurrentSince Nov 3, 2024 Accepting new patients
Southern California Permanente Medical Group Single Specialty Current Accepting new patients

Locations

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

25965 Normandie Ave
Harbor City, CA 90710
Phone (424) 328-2110

25975 Normandie Ave
Harbor City, CA 90710
Phone (310) 517-3509

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

1820 S Elena Ave
Ste H
Redondo Beach, CA 90277
Phone (310) 489-3304

Organizations & group practices 4

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": "1460160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730505600000",
    "number": "1427412048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 S ELENA AVE STE H",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 S ELENA AVE STE H",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775700",
            "telephone_number": "310-489-3304",
            "fax_number": "310-695-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULLIN",
        "first_name": "WHITNEY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-09",
        "last_updated": "2024-11-02",
        "certification_date": "2024-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A157612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.