Individual provider Active NPI

Wayne Jacinto Ulit, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1518005289
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A51430 Issued in CA
Practice address
2105 Beverly Blvd
Suite125
Los Angeles, CA 90057-2216
Phone
(213) 413-8765
NPI assigned
Feb 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A51430 CA Primary

Addresses

Primary practice location

2105 Beverly Blvd
Suite125
Los Angeles, CA 90057-2216

Mailing address

24108 Hatteras St
Woodland Hills, CA 91367-4038
Phone (213) 413-8765

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
A51430CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518005289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24108 HATTERAS ST",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913674038",
            "telephone_number": "213-413-8765",
            "fax_number": "213-353-9375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 BEVERLY BLVD",
            "address_2": "SUITE125",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572216",
            "telephone_number": "213-413-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULIT",
        "first_name": "WAYNE",
        "middle_name": "JACINTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A51430",
            "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 8, 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.