Individual provider Active NPI

Cindy Haslam, FNP-BC

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1710401229
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95019857 Issued in CA
Practice address
2208 W 7TH St
Los Angeles, CA 90057-4002
Phone
(213) 384-3434
NPI assigned
Jul 27, 2017
Last updated
May 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95019857 CA Primary
Gastroenterology Registered Nurse 163WG0100X 95063355 CA

Addresses

Primary practice location

2208 W 7TH St
Los Angeles, CA 90057-4002

Mailing address

3657 E 4TH St
Los Angeles, CA 90063-3916
Phone (323) 453-7272

Other practice location 1

3056 Fletcher Dr
Los Angeles, CA 90065-2207
Phone (323) 256-2231

Other identifiers 1

IdentifierTypeStateIssuer
95019857OtherCANURSE PRACTITIONER

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
I20220601001644 CA Practitioner - Nurse Practitioner 8022496199 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
El Monte Clinica Medica General Medical Center, Inc CurrentSince May 15, 2022 Accepting new patients
Los Angeles Clinica Medica General Medical Center, Inc. CurrentSince May 15, 2022 Accepting new patients
Amg, a Professional Medical Corp Past Accepting new patients

Locations

11001 Main St
Ste 301
El Monte, CA 91731
Phone (626) 443-4300

2208 W 7th St
Los Angeles, CA 90057
Phone (213) 384-3434

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: cindy.haslam@662570498326532.direct.elationemr.com

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": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1710401229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3657 E 4TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900633916",
            "telephone_number": "323-453-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 W 7TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900574002",
            "telephone_number": "213-384-3434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3056 Fletcher Dr",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900652207",
            "country_code": "US",
            "telephone_number": "323-256-2231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASLAM",
        "first_name": "CINDY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95019857",
            "primary": true
        },
        {
            "code": "163WG0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gastroenterology",
            "state": "CA",
            "license": "95063355",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER",
            "identifier": "95019857",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.