Individual provider Active NPI

Ambujam Panchanathan, M.D.

  • Obstetrics & Gynecology Physician
  • Los Angeles, CA
National Provider Identifier
1730223330
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A32206 Issued in CA
Practice address
2829 S Grand Ave
Los Angeles, CA 90007-3304
Phone
(213) 744-3734
Fax
(213) 765-0537
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 A32206 CA Primary

Addresses

Primary practice location

2829 S Grand Ave
Los Angeles, CA 90007-3304

Mailing address

9741 Donna Ave
Northridge, CA 91324-1822
Phone (818) 993-3034

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
I20151209000570 CA Practitioner - Family Practice 9830490267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Proyecto del Barrio IncGroup PAC ID 3476546227, 27 clinicians

Practice addresses (Care Compare)

18250 Roscoe Blvd
Suite 200
Northridge, CA 91325-4226
Phone (818) 721-4800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A32206CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Proyecto del Barrio, Inc. CurrentSince Oct 1, 2015 Accepting new patients
El Proyecto del Barrio, Inc. Current Accepting new patients
El Proyecto del Barrio, Inc. Current Accepting new patients

Locations

8902 Woodman Ave
Arleta, CA 91331
Phone (818) 830-7033

18250 Roscoe Blvd
#200
Northridge, CA 91325
Phone (818) 721-4800

20800 Sherman Way
Winnetka, CA 91306
Phone (818) 883-2273

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730223330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9741 DONNA AVE",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913241822",
            "telephone_number": "818-993-3034",
            "fax_number": "818-993-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 S GRAND AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900073304",
            "telephone_number": "213-744-3734",
            "fax_number": "213-765-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCHANATHAN",
        "first_name": "AMBUJAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A32206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.