La Vida Multi-Specialty Medical Group

Primary specialty

SpecialistTaxonomy code 174400000X

License

18072 Issued in CA

Legal business name

LA VIDA MULTI-SPECIALTY MEDICAL GROUP

Practice address

1045 Redondo Beach Blvd
Gardena, CA 90247

Phone

(310) 352-4170

Fax

(310) 324-7956

NPI assigned

Jan 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Christopher C Chidi, MD

Title

President

Phone

(310) 214-8677

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629123823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT NO 2834",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90084",
            "telephone_number": "310-214-8677",
            "fax_number": "310-921-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 REDONDO BEACH BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "90247",
            "telephone_number": "310-352-4170",
            "fax_number": "310-324-7956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA VIDA MULTI-SPECIALTY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHIDI",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-214-8677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "18072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0088193",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nhan Ky
• Patrick Kyun
• Nathan Oliver L'Esperance, DDS
• La Casa
• La County Department of Mental Health
• Leslie Ann La, RDH
• Roni Labajo
• Megan Labrado
• Kacie Lackey
• Marianne M Lacoste, MA, ADTR

• Specialist in Gardena, CA
• Providers in Gardena, CA by specialty
• Specialist in California

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.