Good Neighbor Clinic a Medical Corporation

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

GOOD NEIGHBOR CLINIC A MEDICAL CORPORATION

Practice address

4300 Crenshaw Blvd.
Los Angeles, CA 90008

Phone

(323) 298-1668

Fax

(323) 298-0458

NPI assigned

Aug 15, 2014

Organization subpart

No

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

Authorized official

Name

Daniel Shane Sheibani Davidson, MD, MBA, DBA

Title

Administrator

Phone

(310) 212-1500

Specialties & licenses 4

Addresses

Other names 2

• GOOD NEIGHBOR CLINIC, AMC Former legal business name
• Good Neighbor Clinic Crenshaw Boulevard Other name

Locations

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1689073595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 S ALFRED ST UNIT 1064",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900352506",
            "telephone_number": "310-212-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 CRENSHAW BLVD.",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90008",
            "telephone_number": "323-298-1668",
            "fax_number": "323-298-0458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 W Manchester Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900475436",
            "country_code": "US",
            "telephone_number": "323-991-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GOOD NEIGHBOR CLINIC A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-15",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "SHANE SHEIBANI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "310-212-1500",
        "authorized_official_credential": "MD, MBA, DBA"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A31491",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GOOD NEIGHBOR CLINIC, AMC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Good Neighbor Clinic Crenshaw Boulevard",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Good Neighbor Clinic Crenshaw Boulevard",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.