Irvin Fragoso

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

6736 Laurel Canyon Blvd Ste 200
North Hollywood, CA 91606

Phone

(818) 755-8784

NPI assigned

Jun 5, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1487034278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6736 LAUREL CANYON BLVD STE 200",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916061576",
            "telephone_number": "818-755-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6736 LAUREL CANYON BLVD STE 200",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "91606",
            "telephone_number": "818-755-8784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12099 W Washington Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900665882",
            "country_code": "US",
            "telephone_number": "818-355-9180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRAGOSO",
        "first_name": "IRVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-05",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.