NPIMap

Organization Active NPI

Los Angeles County - Widney Mtu

  • Rehabilitation Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1497939193
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
LOS ANGELES COUNTY - WIDNEY MTU
Practice address
2302 S Gramercy PL
Los Angeles, CA 90018-1323
Phone
(323) 731-8442
Fax
(323) 733-2486
NPI assigned
Dec 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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

Authorized official

Name
Mr. Wesley L Ford, M.A., M.P.H.
Title
Director
Phone
(626) 569-6001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

2302 S Gramercy PL
Los Angeles, CA 90018-1323

Mailing address

9320 Telstar Ave Ste 226
El Monte, CA 91731-2816
Phone (800) 288-4584

Other identifiers 1

IdentifierTypeStateIssuer
CCS00135FMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Usc Caruso Department Otolaryngology-Head and Neck Surgery612 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2302 S Gramercy Pl
Los Angeles, CA 90018
Phone (323) 731-8442

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197936000000",
    "number": "1497939193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9320 TELSTAR AVE STE 226",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917312816",
            "telephone_number": "800-288-4584",
            "fax_number": "626-569-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 S GRAMERCY PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900181323",
            "telephone_number": "323-731-8442",
            "fax_number": "323-733-2486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES COUNTY - WIDNEY MTU",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-18",
        "last_updated": "2007-12-18",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "626-569-6001",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.A., M.P.H."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CCS00135F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; 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.