NPIMap

Organization Active NPI

Prime Healthcare Services-Sherman Oaks, LLC

  • Registered Nurse
  • Sherman Oaks, CA
National Provider Identifier
1518348481
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
930000149 Issued in CA
Legal business name
PRIME HEALTHCARE SERVICES-SHERMAN OAKS, LLC
Doing business as
Specialized Ambulatory Geriatric Evaluation
Practice address
4911 Van Nuys Blvd
Suite 307
Sherman Oaks, CA 91403-1716
Phone
(818) 341-7243
Fax
(818) 478-2925
NPI assigned
Jun 16, 2015
Organization subpart
Yes
Parent organization
PRIME HEALTHCARE SERVICES-SHERMAN OAKS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Authorized official

Name
Mr. Christopher Doan, ESQ.
Title
Chief Compliance Counsel
Phone
(909) 235-4307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X 930000149 CA Primary

Addresses

Primary practice location

4911 Van Nuys Blvd
Suite 307
Sherman Oaks, CA 91403-1716

Mailing address

4929 Van Nuys Blvd
Sherman Oaks, CA 91403-1702
Phone (818) 961-7111

Other names 1

  • Specialized Ambulatory Geriatric Evaluation Doing business as

National Provider Directory

National Provider Directory
Part of
Center for Senior Care

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1518348481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4929 VAN NUYS BLVD",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031702",
            "telephone_number": "818-961-7111",
            "fax_number": "818-907-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4911 VAN NUYS BLVD",
            "address_2": "SUITE 307",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031716",
            "telephone_number": "818-341-7243",
            "fax_number": "818-478-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES-SHERMAN OAKS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIME HEALTHCARE SERVICES-SHERMAN OAKS, LLC",
        "enumeration_date": "2015-06-16",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE COUNSEL",
        "authorized_official_telephone_number": "909-235-4307",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "930000149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Specialized Ambulatory Geriatric Evaluation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.