Lilly Wilen M.D. a Medical Corporation

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

A61876 Issued in CA

Legal business name

LILLY WILEN M.D. A MEDICAL CORPORATION

Practice address

17075 Devonshire St
Suite 306
Northridge, CA 91325-1600

Phone

(818) 831-3228

Fax

(818) 831-3447

NPI assigned

Jan 15, 2007

Organization subpart

No

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

Authorized official

Name

Lilly Wilen, M.D.NPI 1275553679

Title

Owner

Phone

(818) 831-3227

Specialties & licenses 1

Addresses

Other names 1

• New Concepts Medical Group Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Lilly Liping Wilen, M.D.

  • Internal Medicine Physician
  • Northridge, CA
  • NPI 1275553679
  Medicare reassignment Care Compare group NPD Authorized official
• A Kolluru, M.D.

  • Internal Medicine Physician
  • Burbank, CA
  • NPI 1598052607
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325721600000",
    "number": "1619028008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST",
            "address_2": "SUITE 306",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913251600",
            "telephone_number": "818-831-3227",
            "fax_number": "818-831-3447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST",
            "address_2": "SUITE 306",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913251600",
            "telephone_number": "818-831-3228",
            "fax_number": "818-831-3447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILLY WILEN M.D. A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2012-01-05",
        "status": "A",
        "authorized_official_last_name": "WILEN",
        "authorized_official_first_name": "LILLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-831-3227",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A61876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Concepts Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Liang Wang, MD Inc
• Lif Hospice Care, Inc.
• Life Care Partners Inc.
• Lifted Foundation LLC
• Lifted Together Inc Licensed Clinical Social Worker
• Megan Lim, PT, DPT
• Alex Ling Lin, M.D.
• Justine Yintine Lin
• Paula Lin, LMFT
• Ya-Jan Lin

• Medical Specialty Clinic/Center in Northridge, CA
• Providers in Northridge, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.