Active NPI
Costa Via
- Peer Specialist
- Lawndale, CA
National Provider Identifier
1497523682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- MPSS-HNGJYI
- Practice address
- 4580 W 173Rd St Apt 115
Lawndale, CA 90260-3440 - Phone
- (310) 421-4233
- NPI assigned
- Dec 18, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | MPSS-HNGJYI | CA | Primary |
Addresses
Primary practice location
4580 W 173Rd St Apt 115
Lawndale, CA 90260-3440
Mailing address
4580 W 173Rd St Apt 115
Lawndale, CA 90260-3440
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MPSS-HNGJYI | CA | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702857600000",
"number": "1497523682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4580 W 173RD ST APT 115",
"city": "LAWNDALE",
"state": "CA",
"postal_code": "902603440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4580 W 173RD ST APT 115",
"city": "LAWNDALE",
"state": "CA",
"postal_code": "902603440",
"telephone_number": "310-421-4233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIA",
"first_name": "COSTA",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-12-18",
"last_updated": "2023-12-18",
"certification_date": "2023-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Peer Specialist",
"state": "CA",
"license": "MPSS-HNGJYI",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawndale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.