NPIMap

Organization Active NPI

Thrive Health IV Clinic PC

  • Multi-Specialty Clinic/Center
  • Sherman Oaks, CA
National Provider Identifier
1497615686
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
THRIVE HEALTH IV CLINIC PC
Practice address
4849 Van Nuys Blvd Ste 202a
Sherman Oaks, CA 91403-2110
Phone
(310) 363-8757
Fax
(310) 363-8758
NPI assigned
Nov 12, 2025
Last updated
Nov 12, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
THRIVE HEALTH IV CLINIC PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Authorized official

Name
Raymond S Douglas, MD, PHDNPI 1124041959
Title
President
Phone
(310) 657-4302

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

4849 Van Nuys Blvd Ste 202a
Sherman Oaks, CA 91403-2110

Mailing address

9675 Brighton Way Ste 410
Beverly Hills, CA 90210-5192
Phone (310) 363-8757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230622000890 CA Part B Supplier - Clinic/Group Practice 0941668057 Receives reassigned benefits from 10 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sherman Oaks, CA; Beverly Hills, CA; Santa Monica, CA; Rancho Palos Verdes, CA; Long Beach, CA; Newport Beach, CA

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Thrive Health IV CLN PC16 organizations share this tax ID, including this one
Part of
Thrive Health IV CLN PC

Other organizations with this tax ID 15

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

View all 15

Locations

9675 Brighton Way
Ste 410
Beverly Hills, CA 90210
Phone (310) 274-2525

28633 S Western Ave
Ste 202
Rancho Palos Verdes, CA 90275
Phone (310) 241-0947

8940 N Kendall Dr
Ste 400E
Miami, FL 33176
Phone (305) 598-2020

2001 N Halsted St
Chicago, IL 60614

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1762905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762905600000",
    "number": "1497615686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9675 BRIGHTON WAY STE 410",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105192",
            "telephone_number": "310-363-8757",
            "fax_number": "310-363-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 VAN NUYS BLVD STE 202A",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032110",
            "telephone_number": "310-363-8757",
            "fax_number": "310-363-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVE HEALTH IV CLINIC PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THRIVE HEALTH IV CLINIC PC",
        "enumeration_date": "2025-11-12",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-657-4302",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.