NPIMap

Individual provider Active NPI

Diane Elizabeth Brown, MD

  • Pediatric Rheumatology Physician
  • Los Angeles, CA
National Provider Identifier
1649298282
Registry record updated Mar 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X
License
2004024401 Issued in MO
Practice address
4650 Sunset Blvd.
Los Angeles, CA 90027-6062
Phone
(314) 454-6124
Fax
(314) 454-4633
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rheumatology Physician 2080P0216X 2004024401 MO Primary

Addresses

Primary practice location

4650 Sunset Blvd.
Los Angeles, CA 90027-6062

Mailing address

6430 Sunset Blvd.
Suite 600
Los Angeles, CA 90028-7900
Phone (323) 361-2337

Other practice location 1

1 Breakthrough Way
Las Vegas, NV 89135-3011
Phone (702) 732-1493

Other identifiers 1

IdentifierTypeStateIssuer
206177107MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070828001002 CA Practitioner - RheumatologyPractitioner - Pediatric Medicine 7012967243 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
100480CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Los Angeles Medical Group, Inc. CurrentSince Jun 27, 2016 Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Dignity Health Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Children's Hospital Los Angeles Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients

Locations

3701 Wilshire Blvd
Ste 600
Los Angeles, CA 90010
Phone (323) 361-3550

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1649298282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6430 SUNSET BLVD.",
            "address_2": "SUITE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287900",
            "telephone_number": "323-361-2337",
            "fax_number": "323-361-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 SUNSET BLVD.",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "314-454-6124",
            "fax_number": "314-454-4633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Breakthrough Way",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891353011",
            "country_code": "US",
            "telephone_number": "702-732-1493",
            "fax_number": "702-732-1080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DIANE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "MO",
            "license": "2004024401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206177107",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.