Individual provider Active NPI

Vitaliy Yudkin

  • Chiropractor
  • Los Angeles, CA
National Provider Identifier
1730380643
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC27197 Issued in CA
Practice address
7260 W Sunset Blvd Ste 204
Los Angeles, CA 90046-3417
Phone
(323) 851-7804
Fax
(323) 851-7878
NPI assigned
May 29, 2007
Sex
Male
Sole proprietor
Yes

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
Chiropractor 111N00000X DC27197 CA Primary

Addresses

Primary practice location

7260 W Sunset Blvd Ste 204
Los Angeles, CA 90046-3417

Mailing address

7260 W Sunset Blvd Ste 204
Los Angeles, CA 90046-3417
Phone (323) 851-7804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050103000409 CA Practitioner - Chiropractic 9638137946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7260 W Sunset Blvd
Suite 204
Los Angeles, CA 90046-3417
Phone (323) 851-7804

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC27197CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Yudkin Healing Hands Chiropractic Chiropractor CurrentSince Jan 2, 2020 Accepting new patients

Locations

7260 W Sunset Blvd
Ste 204
Los Angeles, CA 90046
Phone (323) 851-7804

Organizations & group practices 1

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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730380643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7260 W SUNSET BLVD STE 204",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900463417",
            "telephone_number": "323-851-7804",
            "fax_number": "323-851-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7260 W SUNSET BLVD STE 204",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900463417",
            "telephone_number": "323-851-7804",
            "fax_number": "323-851-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUDKIN",
        "first_name": "VITALIY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC27197",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.