Innovage California Pace - Los Angeles, LLC

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

INNOVAGE CALIFORNIA PACE - LOS ANGELES, LLC

Practice address

12130 Paramount Blvd
Downey, CA 90242-2339

Phone

(720) 454-3186

NPI assigned

Jan 16, 2026

Last updated

Jan 16, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Cody Robertson

Title

Associate General Counsel

Phone

(720) 454-3186

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1768521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768521600000",
    "number": "1568321578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 E LOWRY BLVD",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307030",
            "telephone_number": "720-454-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12130 PARAMOUNT BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902422339",
            "telephone_number": "720-454-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVAGE CALIFORNIA PACE - LOS ANGELES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-16",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "720-454-3186",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• PACE Provider Organization in Downey, CA
• Providers in Downey, CA by specialty
• PACE Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.