Organization Active NPI

Philip M. Lichtenfeld MD, Professional Corp.

  • Multi-Specialty Clinic/Center
  • Encino, CA
National Provider Identifier
1609921659
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PHILIP M. LICHTENFELD MD, PROFESSIONAL CORP.
Practice address
16550 Ventura Blvd
Suite 320
Encino, CA 91436-2004
Phone
(818) 784-7784
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Philip LichtenfeldNPI 1295880227
Title
President
Phone
(818) 784-7784

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

16550 Ventura Blvd
Suite 320
Encino, CA 91436-2004

Mailing address

16550 Ventura Blvd
Suite 320
Encino, CA 91436-2004

Other names 1

  • Encino Physicians Medical Group Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0560971Philip Lichtenfeld MD16550 Ventura Blvd Suite 320, Encino, CA 91436Provider-performed microscopyMar 25, 2028

National Provider Directory

National Provider Directory

Locations

16550 Ventura Blvd
Ste 320
Encino, CA 91436
Phone (818) 784-7784

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609921659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16550 VENTURA BLVD",
            "address_2": "SUITE 320",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16550 VENTURA BLVD",
            "address_2": "SUITE 320",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362004",
            "telephone_number": "818-784-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP M. LICHTENFELD MD, PROFESSIONAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LICHTENFELD",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-784-7784"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Encino Physicians Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.