Active NPI
Brian H. Itagaki M.D., Inc.
- Orthopaedic Surgery Physician
- Los Angeles, CA
National Provider Identifier
1710023718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- G37936
- Legal business name
- BRIAN H. ITAGAKI M.D., INC.
- Practice address
- 2200 W 3Rd St
Suite 120a
Los Angeles, CA 90057-1932 - Phone
- (213) 484-7303
- Fax
- (213) 484-7399
- NPI assigned
- Jan 29, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Brian Hiro Itagaki, M.D.
- Title
- President
- Phone
- (213) 484-7303
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | G37936 | CA | Primary |
Addresses
Primary practice location
2200 W 3Rd St
Suite 120a
Los Angeles, CA 90057-1932
Mailing address
2200 W 3Rd St
120A
Los Angeles, CA 90057-1932
Phone (213) 484-7303
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G379360 | Medicaid | CA | |
| 006379360 | Other | CA | BLUE SHIELD |
| 155649300 | Other | CA | DEPARTMENT OF LABOR |
| 0004227410 | Other | CA | AETNA |
| G37936 | Other | CA | MEDICARE INDIVIDUAL PTAN |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1365724800000",
"number": "1710023718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 W 3RD ST",
"address_2": "120A",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900571932",
"telephone_number": "213-484-7303",
"fax_number": "213-484-7399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 W 3RD ST",
"address_2": "SUITE 120A",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900571932",
"telephone_number": "213-484-7303",
"fax_number": "213-484-7399"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRIAN H. ITAGAKI M.D., INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-29",
"last_updated": "2013-04-12",
"status": "A",
"authorized_official_last_name": "ITAGAKI",
"authorized_official_first_name": "BRIAN",
"authorized_official_middle_name": "HIRO",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "213-484-7303",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "G37936",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G379360",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "006379360",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF LABOR",
"identifier": "155649300",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0004227410",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE INDIVIDUAL PTAN",
"identifier": "G37936",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.