Individual provider Active NPI

Michael Gottlieb, M.E.

  • Behavior Analyst
  • Los Angeles, CA
National Provider Identifier
1467867499
Registry record updated Jun 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
D3213930 Issued in CA
Practice address
3724 1/2 Corinth Ave
Los Angeles, CA 90066-3440
Phone
(310) 496-4826
NPI assigned
Jun 28, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X D3213930 CA Primary

Addresses

Primary practice location

3724 1/2 Corinth Ave
Los Angeles, CA 90066-3440

Mailing address

3724 1/2 Corinth Ave
Los Angeles, CA 90066-3440
Phone (310) 496-4826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Engineering

State licenses

LicenseStateTypeSpecialty
D3213930CAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1403913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403913600000",
    "number": "1467867499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3724 1/2 CORINTH AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900663440",
            "telephone_number": "310-496-4826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3724 1/2 CORINTH AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900663440",
            "telephone_number": "310-496-4826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "MICHAEL",
        "credential": "M.E.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-28",
        "last_updated": "2014-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "D3213930",
            "primary": true
        }
    ],
    "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 Jun 28, 2014; 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.