Active NPI
Corneliu Balan
- Registered Nurse
- Los Angeles, CA
National Provider Identifier
1639997836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 95108121
- Practice address
- 1625 Schrader Blvd
Los Angeles, CA 90028-6213 - Phone
- (323) 993-7521
- NPI assigned
- Sep 27, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 95108121 | CA | Primary |
Addresses
Primary practice location
1625 Schrader Blvd
Los Angeles, CA 90028-6213
Mailing address
1625 Schrader Blvd
Los Angeles, CA 90028-6213
Phone (323) 993-7521
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01536011 | Other | MEDICAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95108121 | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727395200000",
"number": "1639997836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1625 SCHRADER BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900286213",
"telephone_number": "323-993-7521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1625 SCHRADER BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900286213",
"telephone_number": "323-993-7521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALAN",
"first_name": "CORNELIU",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-09-27",
"last_updated": "2024-09-27",
"certification_date": "2024-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "95108121",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "01536011",
"state": null
}
],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.