Individual provider Active NPI

Haley Legan, PA

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1700617859
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1700 E Cesar E Chavez Ave
Los Angeles, CA 90033-2424
Phone
(855) 522-3682
NPI assigned
Aug 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1700 E Cesar E Chavez Ave
Los Angeles, CA 90033-2424

Mailing address

1700 E Cesar E Chavez Ave
Los Angeles, CA 90033-2424

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250415002765 CA Practitioner - Physician Assistant 4587189287 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
65335CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Employee Medical Consultants PC Past Accepting new patients
Citrus Valley Medical Associates, Inc. PastSince Aug 2, 2021 Accepting new patients
Samir a Shah MD Professional Corporation Past Accepting new patients
Michael R. Gatto MD, Inc. PastSince Aug 1, 2007 Accepting new patients

Organizations & group practices 5

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": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1700617859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E CESAR E CHAVEZ AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E CESAR E CHAVEZ AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332424",
            "telephone_number": "855-522-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGAN",
        "first_name": "HALEY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.