Organization Active NPI

Concerto Health Pace of Los Angeles, LLC

  • PACE Provider Organization
  • Los Angeles, CA
National Provider Identifier
1649934738
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
CONCERTO HEALTH PACE OF LOS ANGELES, LLC
Practice address
3670 Degnan Boulevard
Los Angeles, CA 90018
Phone
(213) 328-9666
NPI assigned
Oct 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Authorized official

Name
Jennifer Bryant
Title
SVP, General Counsel and Compliance
Phone
(949) 689-9526

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X Primary

Addresses

Primary practice location

3670 Degnan Boulevard
Los Angeles, CA 90018

Mailing address

21750 Hardy Oak Blvd., Ste. 104, PMB 72961
San Antonio, TX 78258-4946
Phone (877) 597-1440

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1649934738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21750 HARDY OAK BLVD., STE. 104, PMB 72961",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584946",
            "telephone_number": "877-597-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3670 DEGNAN BOULEVARD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90018",
            "telephone_number": "213-328-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCERTO HEALTH PACE OF LOS ANGELES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "SVP, GENERAL COUNSEL AND COMPLIANCE",
        "authorized_official_telephone_number": "949-689-9526"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "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 Oct 26, 2021; 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.