Michele Lynn Sundaram, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A7566 Issued in CA

Practice address

2101 Hillhurst Ave
Los Angeles, CA 90027-2003

Phone

(323) 664-2931

Fax

(323) 664-8931

NPI assigned

Dec 1, 2005

Last updated

Nov 5, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Michele Lynn Ware Professional name

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Michael Burton M D a Medical Group Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1114940061
  Medicare reassignment NPD

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1497739528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3428 GRIFFITH PARK BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900271403",
            "telephone_number": "323-661-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 HILLHURST AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900272003",
            "telephone_number": "323-664-2931",
            "fax_number": "323-664-8931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDARAM",
        "first_name": "MICHELE",
        "middle_name": "LYNN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A7566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020A75660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "WARE",
            "middle_name": "LYNN",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Sun's Holistic Acupuncture Inc
• Sun's Holistic Acupuncture Inc.
• Sun's Holistic Acupunture, Inc
• Sunbridge Meadowbrook Rehabilitation Center (Meadowbrook Behavioral Health Center)
• Jawahar Sundaram, MD
• Pavithra Sundaravaradan
• Santosh Kumar Sundaresan
• Sunday Pediatrics a Professional Corporation
• Dianne Y. Sundby, PH.D.
• Tiffany Ann Sunde, PSYD MFT

• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.