Paletz Agatstein Urology Medical GRP Inc

Key facts

NPI

1740324060

Entity type

Organization (NPI type 2)

Primary specialty

Urology Physician 208800000X

License

A035498 (CA)

Legal business name

PALETZ AGATSTEIN UROLOGY MEDICAL GRP INC

Practice address

575 E Hardy St
Suite 215
Inglewood, CA 90301-4036

Phone

(310) 673-3333

Fax

(310) 673-1714

NPI assigned

Feb 19, 2007

Organization subpart

No

Authorized official

Name

Dr. Lawrence Paletz, MD

Title

President

Phone

(310) 673-3333

Practitioners 7

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

• Yasmin Ayoka Alaran Physician Assistant · Downey, CA · NPI 1962045922
  NPD
• Jasmina Dukovic, PA-C Physician Assistant · Downey, CA · NPI 1457021677
  NPD
• Paul Lee Physician Assistant · Downey, CA · NPI 1144996745
  NPD
• Adam Gregory Mogil, PA-C Physician Assistant · Sherman Oaks, CA · NPI 1245345933
  NPD
• Robert Glenn Pugach, MD Specialist · Los Alamitos, CA · NPI 1780687319
  NPD
• Evans Phung Tran, PA Physician Assistant · Los Alamitos, CA · NPI 1750632253
  NPD
• Jose Lopez, PAC Physician Assistant · Los Angeles, CA · NPI 1245364785
  NPD (past)

National Provider Directory

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD
  Plans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Specialties & licenses

Addresses

Other identifiers

Other names

• West Coast Urology Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 31, 2021.

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1740324060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 E HARDY ST",
            "address_2": "SUITE 215",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014036",
            "telephone_number": "310-673-3333",
            "fax_number": "310-673-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 E HARDY ST",
            "address_2": "SUITE 215",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014036",
            "telephone_number": "310-673-3333",
            "fax_number": "310-673-1714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALETZ AGATSTEIN UROLOGY MEDICAL GRP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A",
        "authorized_official_last_name": "PALETZ",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-673-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "A035498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR20092241",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Coast Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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