NPIMap

Organization Active NPI

Pediatric and Family Medical Center

Doing business as Eisner Health Dermatology at Sherman Oaks

  • Federally Qualified Health Center (FQHC)
  • Sherman Oaks, CA
National Provider Identifier
1477103299
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PEDIATRIC AND FAMILY MEDICAL CENTER
Doing business as
Eisner Health Dermatology at Sherman Oaks
Practice address
15477 Ventura Blvd Ste 100
Sherman Oaks, CA 91403-3046
Phone
(213) 747-5542
NPI assigned
Sep 13, 2019
Organization subpart
Yes
Parent organization
PEDIATRIC AND FAMILY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
Monica McCarthy
Title
Sr VP, Coo & Interim-Ceo
Phone
(213) 747-5542

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

15477 Ventura Blvd Ste 100
Sherman Oaks, CA 91403-3046

Mailing address

1530 S Olive St
Los Angeles, CA 90015-3023
Phone (213) 747-5542

Other names 1

  • EISNER HEALTH DERMATOLOGY AT SHERMAN OAKS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Family Medical C13 organizations share this tax ID, including this one
Part of
Pediatric Family Medical C

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1477103299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 S OLIVE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153023",
            "telephone_number": "213-747-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15477 VENTURA BLVD STE 100",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033046",
            "telephone_number": "213-747-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC AND FAMILY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEDIATRIC AND FAMILY MEDICAL CENTER",
        "enumeration_date": "2019-09-13",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "SR VP, COO & INTERIM-CEO",
        "authorized_official_telephone_number": "213-747-5542"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EISNER HEALTH DERMATOLOGY AT SHERMAN OAKS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EISNER HEALTH DERMATOLOGY AT SHERMAN OAKS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.