Active NPI
Andrew R Dow, M.D.
- Psychiatry Physician
- Culver City, CA
National Provider Identifier
1477636504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0101031567
- Practice address
- 4760 Sepulveda Blvd
Culver City, CA 90230-4820 - Phone
- (310) 390-6612
- Fax
- (310) 398-5590
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 056282 | GA | |
| Psychiatry Physician | 2084P0800X | 0101031567 | VA | Primary |
| Psychiatry Physician | 2084P0800X | G140359 | CA |
Addresses
Primary practice location
4760 Sepulveda Blvd
Culver City, CA 90230-4820
Mailing address
4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone (310) 390-6612
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890467547A | Medicaid | GA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- University of Alabama School of Medicine, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone (310) 390-6612
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G140359 | CA | MD | Psychiatry Physician |
| 0101031567 | VA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Didi Hirsch Psychiatric Service | Current | Accepting new patients | |
| Didi Hirsch Psychiatric Service | Current | Accepting new patients | |
| Carilion Emergency Services Inc | Past | Accepting new patients | |
| CHS Inc | Past | Accepting new patients |
Locations
4760 Sepulveda Blvd
Los Angeles, CA 90230
Phone (310) 751-5344
Interoperability endpoints
- adow150725@direct.llu.edu
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Culver City, CA
- NPI 1730299959
-
- Substance Abuse Rehabilitation Facility
- Pacoima, CA
- NPI 1740539980
-
- Emergency Medicine Physician
- Roanoke, VA
- NPI 1700839958
-
- Community/Retail Pharmacy
- Salem, VA
- NPI 1538493382
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470700800000",
"number": "1477636504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4760 SEPULVEDA BLVD",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902304820",
"telephone_number": "310-390-6612",
"fax_number": "310-398-5590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4760 SEPULVEDA BLVD",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902304820",
"telephone_number": "310-390-6612",
"fax_number": "310-398-5590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOW",
"first_name": "ANDREW",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2016-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "GA",
"license": "056282",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0101031567",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G140359",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890467547A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.