Individual provider Active NPI

Ronald Joseph Wahlig, M.D.

  • Anesthesiology Physician
  • Los Angeles, CA
National Provider Identifier
1518071984
Registry record updated Mar 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G76939 Issued in CA
Practice address
2476 Overland Ave
Suite 201
Los Angeles, CA 90064-3374
Phone
(310) 559-8276
Fax
(310) 559-8263
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G76939 CA Primary

Addresses

Primary practice location

2476 Overland Ave
Suite 201
Los Angeles, CA 90064-3374

Mailing address

2476 Overland Ave
Suite 201
Los Angeles, CA 90064-3374
Phone (310) 559-8276

Other identifiers 1

IdentifierTypeStateIssuer
00G769390MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120427000399 CA Practitioner - Anesthesiology 5890957443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Southern California Keck School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12400 Wilshire Blvd
Suite 100
Los Angeles, CA 90025-1067
Phone (310) 422-5566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G76939CAMDAnesthesiology Physician
76939CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ronald J Wahlig, MD, Inc Anesthesiology CurrentSince Jul 1, 1995 Accepting new patients

Locations

12400 Wilshire Blvd
Ste 100
Los Angeles, CA 90025
Phone (310) 422-5566

2476 Overland Ave
Ste 201
Los Angeles, CA 90064

Organizations & group practices 1

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1518071984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2476 OVERLAND AVE",
            "address_2": "SUITE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900643374",
            "telephone_number": "310-559-8276",
            "fax_number": "310-559-8263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2476 OVERLAND AVE",
            "address_2": "SUITE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900643374",
            "telephone_number": "310-559-8276",
            "fax_number": "310-559-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHLIG",
        "first_name": "RONALD",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G76939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G769390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.