NPIMap

Organization Active NPI

Assuta Family Medical Group a Professional Medical Corporation

  • Family Medicine Physician
  • North Hollywood, CA
National Provider Identifier
1639400260
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A82603 Issued in CA
Legal business name
ASSUTA FAMILY MEDICAL GROUP A PROFESSIONAL MEDICAL CORPORATION
Practice address
12922 Victory Blvd
North Hollywood, CA 91606-2924
Phone
(818) 760-2800
Fax
(818) 760-7343
NPI assigned
Jan 21, 2010
Last updated
Jul 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Authorized official

Name
Nataraj Chandrasekhar
Title
Manager
Phone
(818) 760-2800

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A82603 CA Primary
Internal Medicine Physician 207R00000X A33650 CA
Surgical Oncology Physician 2086X0206X A60294 CA
Urology Physician 208800000X A60294 CA

Addresses

Primary practice location

12922 Victory Blvd
North Hollywood, CA 91606-2924

Mailing address

12922 Victory Blvd
North Hollywood, CA 91606-2924
Phone (818) 760-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100419000547 CA Part B Supplier - Clinic/Group Practice 2860529195 Receives reassigned benefits from 9 practitioners
Practice locations: North Hollywood, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784678400000",
    "number": "1639400260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12922 VICTORY BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916062924",
            "telephone_number": "818-760-2800",
            "fax_number": "818-760-7343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12922 VICTORY BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916062924",
            "telephone_number": "818-760-2800",
            "fax_number": "818-760-7343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSUTA FAMILY MEDICAL GROUP A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A",
        "authorized_official_last_name": "CHANDRASEKHAR",
        "authorized_official_first_name": "NATARAJ",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "818-760-2800"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A82603",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A33650",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "CA",
            "license": "A60294",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A60294",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.