Individual provider Active NPI

Tara Leanne Sedlak, MD

  • Cardiovascular Disease Physician
  • Los Angeles, CA
National Provider Identifier
1508154188
Registry record updated Jul 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A117536 Issued in CA
Practice address
444 S San Vicente Blvd Ste 600
Los Angeles, CA 90048-4174
Phone
(310) 423-9979
NPI assigned
Jul 15, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A117536 CA Primary

Addresses

Primary practice location

444 S San Vicente Blvd Ste 600
Los Angeles, CA 90048-4174

Mailing address

5700 W 6TH St Apt 422
Los Angeles, CA 90036-5820
Phone (310) 691-9563

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A117536CAMDCardiovascular Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1508154188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 W 6TH ST APT 422",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900365820",
            "telephone_number": "310-691-9563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 S SAN VICENTE BLVD STE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900484174",
            "telephone_number": "310-423-9979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDLAK",
        "first_name": "TARA LEANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-15",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A117536",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 15, 2011; 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.