Individual provider Active NPI

Sara Aliza Fenig, PA

  • Medical Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1508327024
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA56415 Issued in CA
Practice address
1435 S Vermont Ave Ste 100
Los Angeles, CA 90006-4543
Phone
(213) 386-2511
NPI assigned
Mar 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA56415 CA Primary

Addresses

Primary practice location

1435 S Vermont Ave Ste 100
Los Angeles, CA 90006-4543

Mailing address

173 S Formosa Ave
Los Angeles, CA 90036-2815
Phone (323) 702-2399

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA56415CAMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1508327024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 S FORMOSA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900362815",
            "telephone_number": "323-702-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 S VERMONT AVE STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900064543",
            "telephone_number": "213-386-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENIG",
        "first_name": "SARA ALIZA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA56415",
            "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 Mar 27, 2019; 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.