Carol Nicole De Walt, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

A95208 Issued in CA

Practice address

3330 Lomita Blvd
Torrance, CA 90505-5002

Phone

(310) 270-7477

NPI assigned

Mar 11, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Carol Nicole Brown Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cedars-Sinai Medical Care Foundation

  • Specialist
  • Los Angeles, CA
  • NPI 1316984388
  Medicare reassignment NPD
• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1639172372
  Medicare reassignment NPD
• County of Los Angeles

  dba County of Los Angeles Harbor UCLA Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment NPD
• Cedars-Sinai Medical Care Foundation

  • Anesthesiology Physician
  • Los Angeles, CA
  • NPI 1043826720
  NPD
• Cedars-Sinai Medical Center

  dba San Vicente Pharmacy

  • Pharmacy
  • Los Angeles, CA
  • NPI 1376514810
  NPD
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1295407401
  NPD
• Cedars-Sinai Medical Center

  • Registered Dietitian
  • West Hollywood, CA
  • NPI 1083785489
  NPD (past)
• UCLA Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1043427248

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1236729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1588805121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2390 CRENSHAW BLVD UNIT 708",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905013300",
            "telephone_number": "310-270-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 LOMITA BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055002",
            "telephone_number": "310-270-7477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2390 Crenshaw Blvd Unit 708",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905013300",
            "country_code": "US",
            "telephone_number": "310-270-7747",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 S Buena Vista St",
            "address_purpose": "LOCATION",
            "city": "Burbank",
            "state": "CA",
            "postal_code": "915054809",
            "country_code": "US",
            "telephone_number": "818-843-5111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8700 Beverly Blvd Ste 4400",
            "address_purpose": "LOCATION",
            "city": "West Hollywood",
            "state": "CA",
            "postal_code": "900481804",
            "country_code": "US",
            "telephone_number": "310-423-4467",
            "fax_number": "310-423-0145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE WALT",
        "first_name": "CAROL",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-11",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A95208",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "A95208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "BROWN",
            "middle_name": "NICOLE",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Neidy Lisbeth De Leon
• Robert De Leon
• Sharina Marie De Leon
• Maria Jasmin De Rosas
• Christian De Virgilio, M.D.
• Dennis Dea, MD
• Dean T. Chiang, M.D. Inc
• Abigail Dean, PT, DPT, CSCS, RRS
• Samantha Deandrade, MD, MPH
• Angelina Marie Dearborn, MA MFT

• Neonatal-Perinatal Medicine Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Neonatal-Perinatal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.