NPIMap

Organization Active NPI

David L. Fogelson, M.D., Inc.

  • Psychiatry Physician
  • Santa Monica, CA
National Provider Identifier
1508030107
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G39149 Issued in CA
Legal business name
DAVID L. FOGELSON, M.D., INC.
Practice address
2730 Wilshire Blvd
Suite 325
Santa Monica, CA 90403-4743
Phone
(310) 828-5015
Fax
(310) 829-3877
NPI assigned
Apr 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Authorized official

Name
David Leslie Fogelson
Title
Owner
Phone
(310) 828-5015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X G39149 CA Primary

Addresses

Primary practice location

2730 Wilshire Blvd
Suite 325
Santa Monica, CA 90403-4743

Mailing address

2730 Wilshire Blvd
Suite 325
Santa Monica, CA 90403-4743

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1508030107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 WILSHIRE BLVD",
            "address_2": "SUITE 325",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 WILSHIRE BLVD",
            "address_2": "SUITE 325",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034743",
            "telephone_number": "310-828-5015",
            "fax_number": "310-829-3877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID L. FOGELSON, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "FOGELSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LESLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-828-5015"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G39149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.