Individual provider Active NPI

Drew Evan Fenton, M.D.

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1508837873
Registry record updated Jul 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G55500 Issued in CA
Practice address
1730 W Olympic Blvd
Suite 100, Ground Floor
Los Angeles, CA 90015-1019
Phone
(213) 247-4000
Fax
(800) 884-7293
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G55500 CA Primary

Addresses

Primary practice location

1730 W Olympic Blvd
Suite 100, Ground Floor
Los Angeles, CA 90015-1019

Mailing address

691 Irolo St Apt 1706
Los Angeles, CA 90005-4137
Phone (213) 247-4000

Other identifiers 1

IdentifierTypeStateIssuer
00G555000MedicaidCA

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G55500CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Family Care Associates Urgent Care Clinic, LLC Past Accepting new patients
Arizona Family Care Associates Urgent Care Clinic, LLC Past Accepting new patients
Central California Emergency Medicine Physicians Family Medicine Past Accepting new patients
Emergency Medical Services Group Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248307200000",
    "number": "1508837873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "691 IROLO ST APT 1706",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900054137",
            "telephone_number": "213-247-4000",
            "fax_number": "800-884-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 W OLYMPIC BLVD",
            "address_2": "SUITE 100, GROUND FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900151019",
            "telephone_number": "213-247-4000",
            "fax_number": "800-884-7293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENTON",
        "first_name": "DREW",
        "middle_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2009-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G55500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G555000",
            "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 Jul 23, 2009; 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.