NPIMap

Organization Active NPI

Usc Care Medical Non-Contracted LLC

Doing business as Usc Care Nephrology

  • Nephrology Physician
  • Los Angeles, CA
National Provider Identifier
1659509206
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
USC CARE MEDICAL NON-CONTRACTED LLC
Doing business as
Usc Care Nephrology
Practice address
1520 San Pablo St
Los Angeles, CA 90033-5310
Phone
(323) 442-5100
NPI assigned
Jun 22, 2009
Last updated
May 1, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
USC CARE MEDICAL GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Authorized official

Name
Jeremy Church
Title
Chief Financial Officer, Usc Care
Phone
(323) 442-8747

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU Primary

Addresses

Primary practice location

1520 San Pablo St
Los Angeles, CA 90033-5310

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (626) 457-4145

Other names 1

  • USC CARE NEPHROLOGY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230612001872 CA Part B Supplier - Clinic/Group Practice 6901263672 Receives reassigned benefits from 26 practitioners
Practice locations: Los Angeles, CA; Arcadia, CA

National Provider Directory

National Provider Directory
Part of
Usc Hlthcre Consult Ctr II

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1510 San Pablo St
Ste 649
Los Angeles, CA 90033

1936 E 1st St
Los Angeles, CA 90033
Phone (323) 268-2729

2310 Alcazar St
Los Angeles, CA 90033
Phone (323) 441-9966

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682899200000",
    "number": "1659509206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "626-457-4145",
            "fax_number": "626-457-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335310",
            "telephone_number": "323-442-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USC CARE MEDICAL NON-CONTRACTED LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "USC CARE MEDICAL GROUP, INC.",
        "enumeration_date": "2009-06-22",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER, USC CARE",
        "authorized_official_telephone_number": "323-442-8747"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "USC CARE NEPHROLOGY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "USC CARE NEPHROLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 1, 2023; 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.