Organization Active NPI

CMC Pulmonary Physiology Laboratory

  • Physiological Laboratory
  • Los Angeles, CA
National Provider Identifier
1740211978
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
CMC PULMONARY PHYSIOLOGY LABORATORY
Practice address
1401 S Grand Ave
Cardiopulmonary Department
Los Angeles, CA 90015-3010
Phone
(213) 742-0910
Fax
(213) 742-6631
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert K. Rothbart, M.D.
Title
Director
Phone
(213) 742-0910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X Primary

Addresses

Primary practice location

1401 S Grand Ave
Cardiopulmonary Department
Los Angeles, CA 90015-3010

Mailing address

2300 S Flower St
#101
Los Angeles, CA 90007-2660
Phone (213) 742-0910

Other identifiers 1

IdentifierTypeStateIssuer
GR0056190MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
CMC Pulmonary Lab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2300 S Flower St
#101
Los Angeles, CA 90007

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740211978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 S FLOWER ST",
            "address_2": "#101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900072660",
            "telephone_number": "213-742-0910",
            "fax_number": "213-742-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S GRAND AVE",
            "address_2": "CARDIOPULMONARY DEPARTMENT",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153010",
            "telephone_number": "213-742-0910",
            "fax_number": "213-742-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC PULMONARY PHYSIOLOGY LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROTHBART",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "213-742-0910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0056190",
            "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 Aug 22, 2020; 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.