Individual provider Active NPI

Kristen Ego Obiakor, MD, MS

  • Pediatrics Physician
  • Santa Monica, CA
National Provider Identifier
1699330043
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A197136 Issued in CA
Practice address
1245 16TH St Ste 125
Santa Monica, CA 90404-1240
Phone
(310) 315-8900
NPI assigned
May 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A197136 CA Primary

Addresses

Primary practice location

1245 16TH St Ste 125
Santa Monica, CA 90404-1240

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707

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
I20240913003466 CA Practitioner - Pediatric Medicine 1355743402 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A197136CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Nov 1, 2024 Accepting new patients
UC Regents Pediatrics CurrentSince Nov 1, 2024 Accepting new patients
The Regents of the University of California CurrentSince Nov 1, 2024 Accepting new patients

Locations

24302 Paseo de Valencia
Ste 200
Laguna Hills, CA 92653
Phone (949) 458-8252

200 UCLA Medical Plz
Ste 265
Los Angeles, CA 90095
Phone (310) 206-2429

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

File 55737
Los Angeles, CA 90074

10833 Le Conte Ave
#12311
Los Angeles, CA 90095
Phone (310) 825-9124

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

892 Aerovista Pl
Ste 240
San Luis Obispo, CA 93401
Phone (805) 541-8252

892 Aerovista Pl
Ste 210
San Luis Obispo, CA 93401
Phone (805) 549-8023

1245 16th St
Ste 125
Santa Monica, CA 90404
Phone (310) 315-8900

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

100 Moody Ct
Ste 200
Thousand Oaks, CA 91360
Phone (805) 418-3500

215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435

Interoperability endpoints

  • Direct secure messaging: kobiakor1266513@direct.uclahealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1699330043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 16TH ST STE 125",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041240",
            "telephone_number": "310-315-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBIAKOR",
        "first_name": "KRISTEN",
        "middle_name": "EGO",
        "credential": "MD, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-01",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A197136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.