Active NPI
Kaiser Permanente
- Health Maintenance Organization
- Los Angeles, CA
National Provider Identifier
1629272026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Maintenance Organization
- License
- MFC 29835
- Legal business name
- KAISER PERMANENTE
- Practice address
- 5105 W Goldleaf Cir
Los Angeles, CA 90056-1269 - Phone
- (323) 298-3100
- Fax
- (323) 298-3119
- NPI assigned
- Jun 12, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Walter Joseph Delorrell Jr., MFT
- Title
- Licensed Psychotherapist
- Phone
- (323) 298-3100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Maintenance Organization | 302R00000X | MFC 29835 | CA | Primary |
Addresses
Primary practice location
5105 W Goldleaf Cir
Los Angeles, CA 90056-1269
Mailing address
10876 Marietta Ave
Culver City, CA 90232-3714
Phone (310) 836-7195
National Provider Directory
National Provider DirectoryLocations
5105 W Goldleaf Cir
Los Angeles, CA 90056
Phone (323) 298-3100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1629272026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10876 MARIETTA AVE",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902323714",
"telephone_number": "310-836-7195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5105 W GOLDLEAF CIR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900561269",
"telephone_number": "323-298-3100",
"fax_number": "323-298-3119"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KAISER PERMANENTE",
"organizational_subpart": "NO",
"enumeration_date": "2007-06-12",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "DELORRELL",
"authorized_official_first_name": "WALTER",
"authorized_official_middle_name": "JOSEPH",
"authorized_official_title_or_position": "LICENSED PSYCHOTHERAPIST",
"authorized_official_telephone_number": "323-298-3100",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "MFT"
},
"taxonomies": [
{
"code": "302R00000X",
"taxonomy_group": "",
"desc": "Health Maintenance Organization",
"state": "CA",
"license": "MFC 29835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.