Organization Active NPI

Noble Physicians Medical Group Corp Inc

  • Internal Medicine Physician
  • West Hollywood, CA
National Provider Identifier
1730561978
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A117709 Issued in CA
Legal business name
NOBLE PHYSICIANS MEDICAL GROUP CORP INC
Practice address
8737 Beverly Blvd Ste 301
West Hollywood, CA 90048-1839
Phone
(323) 765-1500
Fax
(310) 363-7046
NPI assigned
Jun 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Authorized official

Name
David Benjamin Lalezari, MDNPI 1093094427
Title
President
Phone
(818) 430-4000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A117709 CA Primary

Addresses

Primary practice location

8737 Beverly Blvd Ste 301
West Hollywood, CA 90048-1839

Mailing address

PO Box 251247
Los Angeles, CA 90025-9747
Phone (323) 938-9999

Other practice location 1

5901 W Olympic Blvd Ste 404
Los Angeles, CA 90036-4669
Phone (323) 938-9999

Other identifiers 1

IdentifierTypeStateIssuer
A117709OtherCAMEDICAL LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150728004383 CA Part B Supplier - Clinic/Group Practice 2860706348 Receives reassigned benefits from 4 practitioners
Practice locations: Los Angeles, CA; West Hollywood, CA

National Provider Directory

National Provider Directory

Locations

5901 Wilshire Blvd Ste 404
Los Angeles, CA 90036

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1730561978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251247",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900259747",
            "telephone_number": "323-938-9999",
            "fax_number": "323-456-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8737 BEVERLY BLVD STE 301",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481839",
            "telephone_number": "323-765-1500",
            "fax_number": "310-363-7046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5901 W Olympic Blvd Ste 404",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900364669",
            "country_code": "US",
            "telephone_number": "323-938-9999",
            "fax_number": "323-456-0880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOBLE PHYSICIANS MEDICAL GROUP CORP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-24",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "LALEZARI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-430-4000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A117709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A117709",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.