Organization Active NPI

La Weight Loss Corp

  • Surgery Physician
  • Encino, CA
National Provider Identifier
1427562677
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
LA WEIGHT LOSS CORP
Practice address
17609 Ventura Blvd Ste 106
Encino, CA 91316-3866
Phone
(818) 774-2755
Fax
(818) 343-1677
NPI assigned
Nov 27, 2017
Last updated
Mar 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Authorized official

Name
Ara Salazar
Title
Manager
Phone
(818) 774-2755

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

17609 Ventura Blvd Ste 106
Encino, CA 91316-3866

Mailing address

17609 Ventura Blvd Ste 106
Encino, CA 91316-3866
Phone (818) 774-2755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220808002933 CA Part B Supplier - Clinic/Group Practice 8527440510 Receives reassigned benefits from 1 practitioner
Practice locations: Tarzana, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1427562677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17609 VENTURA BLVD STE 106",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163866",
            "telephone_number": "818-774-2755",
            "fax_number": "818-343-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17609 VENTURA BLVD STE 106",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163866",
            "telephone_number": "818-774-2755",
            "fax_number": "818-343-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA WEIGHT LOSS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-27",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "ARA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "818-774-2755"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.