NPIMap

Organization Active NPI

Michael Broukhim, M.D. PC

  • Interventional Cardiology Physician
  • Los Angeles, CA
National Provider Identifier
1457794067
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
A101434 Issued in CA
Legal business name
MICHAEL BROUKHIM, M.D. PC
Practice address
1762 Westwood Blvd
Suite 300
Los Angeles, CA 90024-5632
Phone
(310) 441-2000
NPI assigned
Apr 12, 2013
Last updated
Apr 12, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
INTEGRATED HEALTH CARE MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Authorized official

Name
Dr. Michael Broukhim, M.D.NPI 1609064880
Title
Ceo
Phone
(310) 441-2000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A101434 CA
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X A101434 CA
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X A101434 CA Primary
Medical Specialty Clinic/Center 261QM2500X A101434 CA
General Acute Care Hospital 282N00000X A101434 CA

Addresses

Primary practice location

1762 Westwood Blvd
Suite 300
Los Angeles, CA 90024-5632

Mailing address

1762 Westwood Blvd
Suite 300
Los Angeles, CA 90024-5632
Phone (310) 441-2000

National Provider Directory

National Provider Directory
Part of
Integrated Healthcare Medical Group Inc

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": "1365724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365724800000",
    "number": "1457794067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1762 WESTWOOD BLVD",
            "address_2": "SUITE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245632",
            "telephone_number": "310-441-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1762 WESTWOOD BLVD",
            "address_2": "SUITE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245632",
            "telephone_number": "310-441-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL BROUKHIM, M.D. PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRATED HEALTH CARE MEDICAL GROUP",
        "enumeration_date": "2013-04-12",
        "last_updated": "2013-04-12",
        "status": "A",
        "authorized_official_last_name": "BROUKHIM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-441-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A101434",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A101434",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A101434",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A101434",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "A101434",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.