Individual provider Active NPI

Eduard Minas, MD

  • Obstetrics & Gynecology Physician
  • Los Angeles, CA
National Provider Identifier
1710097670
Registry record updated Jun 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A32118 Issued in CA
Practice address
1300 N Vermont Ave
#705
Los Angeles, CA 90027
Phone
(323) 661-1571
Fax
(323) 661-3969
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A32118 CA Primary

Addresses

Primary practice location

1300 N Vermont Ave
#705
Los Angeles, CA 90027

Mailing address

4618 Fountain Ave
Los Angeles, CA 90029-1977
Phone (323) 669-4323

Other identifiers 1

IdentifierTypeStateIssuer
00A321180MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496880000000",
    "number": "1710097670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4618 FOUNTAIN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291977",
            "telephone_number": "323-669-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N VERMONT AVE",
            "address_2": "#705",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90027",
            "telephone_number": "323-661-1571",
            "fax_number": "323-661-3969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINAS",
        "first_name": "EDUARD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2017-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A32118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A321180",
            "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 Jun 8, 2017; 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.