Ippolytos Andreas Kalofonos, MD, PHD, MPH, MS

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A129889 Issued in CA

Practice address

10940 Wilshire Blvd
710
Los Angeles, CA 90024-3915

Phone

(510) 219-3615

Fax

(310) 794-3288

NPI assigned

May 27, 2010

Last updated

Oct 13, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science, Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pacific Clinics

  • Community/Behavioral Health Agency
  • Irwindale, CA
  • NPI 1821495003
  NPD (past)

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1477872695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10940 WILSHIRE BLVD",
            "address_2": "710",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900243915",
            "telephone_number": "510-219-3615",
            "fax_number": "310-794-3288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10940 WILSHIRE BLVD",
            "address_2": "710",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900243915",
            "telephone_number": "510-219-3615",
            "fax_number": "310-794-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALOFONOS",
        "first_name": "IPPOLYTOS",
        "middle_name": "ANDREAS",
        "name_prefix": "Dr.",
        "credential": "MD, PHD, MPH, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-27",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A129889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Ryan Kallman, MD
• Steven Kallman, DDS
• Kalmansohn & Schiff
• Kalmansohn & Schiff Medical Corporation
• Daryn Kalmus, BCBA
• Bill Kaloostian, M.D.
• Carolyn L. Kaloostian, MD
• Kimberly Ann Kaloustian, MPT
• Tamar Tania Kaloustian, O.D.
• Nathisha Kalpage, MD

• Psychiatry Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.