Organization Active NPI

Valerie L. Watiker M.D. Inc

  • Primary Care Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1669627808
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
A83345 Issued in CA
Legal business name
VALERIE L. WATIKER M.D. INC
Practice address
11633 San Vicente Blvd
Suite 206
Los Angeles, CA 90049-6511
Phone
(310) 360-8383
Fax
(310) 820-1606
NPI assigned
Dec 1, 2008
Last updated
Jan 31, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

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

Authorized official

Name
Dr. Valerie Leigh Watiker, M.D.NPI 1497821763
Title
Ceo
Phone
(310) 360-8383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X A83345 CA Primary

Addresses

Primary practice location

11633 San Vicente Blvd
Suite 206
Los Angeles, CA 90049-6511

Mailing address

11693 San Vicente Blvd
#807
Los Angeles, CA 90049-5105
Phone (310) 360-8383

National Provider Directory

National Provider Directory

Locations

11633 San Vicente Blvd
Ste 206
Los Angeles, CA 90049
Phone (310) 471-5411

Practitioners & affiliated clinicians

Practitioners 3

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": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359590400000",
    "number": "1669627808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11693 SAN VICENTE BLVD",
            "address_2": "#807",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495105",
            "telephone_number": "310-360-8383",
            "fax_number": "310-820-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11633 SAN VICENTE BLVD",
            "address_2": "SUITE 206",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496511",
            "telephone_number": "310-360-8383",
            "fax_number": "310-820-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALERIE L. WATIKER M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-01",
        "last_updated": "2013-01-31",
        "status": "A",
        "authorized_official_last_name": "WATIKER",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-360-8383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A83345",
            "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 Jan 31, 2013; 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.