Individual provider Active NPI

Elilta M. Hagos, M.D., M.P.H

  • Family Medicine Physician
  • Hawthorne, CA
National Provider Identifier
1679706386
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A121648 Issued in CA
Practice address
4455 W 117TH St Ste 200
Hawthorne, CA 90250-2240
Phone
(310) 219-2000
NPI assigned
Aug 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A121648 CA Primary

Addresses

Primary practice location

4455 W 117TH St Ste 200
Hawthorne, CA 90250-2240

Mailing address

4455 W 117TH St Ste 200
Hawthorne, CA 90250-2240
Phone (310) 219-2000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130114000230 CA Practitioner - Family Practice 8224281753 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
79.37
Promoting interoperability
100
Improvement activities
40
Cost
73.65

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Feb 1, 2016 Accepting new patients
Regents of the University of California CurrentSince Feb 1, 2016 Accepting new patients

Locations

2660 W Covell Blvd
Davis, CA 95616
Phone (530) 747-3000

500 University Ave
Ste 220
Sacramento, CA 95825
Phone (916) 286-8700

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1679706386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 W 117TH ST STE 200",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902502240",
            "telephone_number": "310-219-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 W 117TH ST STE 200",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902502240",
            "telephone_number": "310-219-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGOS",
        "first_name": "ELILTA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-27",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A121648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.