NPIMap

Organization Active NPI

Los Angeles County - Gardena Mtu

  • Rehabilitation Clinic/Center
  • Gardena, CA
National Provider Identifier
1689729246
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
LOS ANGELES COUNTY - GARDENA MTU
Practice address
15805 S Budlong Ave
Gardena, CA 90247-4303
Phone
(310) 327-1758
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Shavonda Webber-Christmas
Title
Acting Director. CMS
Phone
(626) 569-6001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

15805 S Budlong Ave
Gardena, CA 90247-4303

Mailing address

9320 Telstar Ave Ste 226
El Monte, CA 91731-2849

Other identifiers 1

IdentifierTypeStateIssuer
CCS00023FMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Usc Caruso Department Otolaryngology-Head and Neck Surgery612 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

15805 S Budlong Ave
Gardena, CA 90247
Phone (310) 327-1758

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": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689729246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9320 TELSTAR AVE STE 226",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917312849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15805 S BUDLONG AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474303",
            "telephone_number": "310-327-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES COUNTY - GARDENA MTU",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEBBER-CHRISTMAS",
        "authorized_official_first_name": "SHAVONDA",
        "authorized_official_title_or_position": "ACTING DIRECTOR. CMS",
        "authorized_official_telephone_number": "626-569-6001"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CCS00023F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.