Individual provider Active NPI

Linda Calvillo King, MD

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1740481639
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C130419 Issued in CA
Practice address
1520 San Pablo St
Suite 1000
Los Angeles, CA 90033-5310
Phone
(323) 442-5100
NPI assigned
May 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10022633 TX
Internal Medicine Physician 207R00000X C130419 CA Primary

Addresses

Primary practice location

1520 San Pablo St
Suite 1000
Los Angeles, CA 90033-5310

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5100

Other identifiers 1

IdentifierTypeStateIssuer
BP1-0022633OtherINSTITUTIONAL PERMIT

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
I20140716001405 CA Practitioner - Internal Medicine 0941373849 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C130419CAMDInternal Medicine Physician
BP10022633TXMDInternal Medicine Physician
TEMPORARYTXMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2014 Accepting new patients
Usc Care Medical Group, Inc Internal Medicine CurrentSince Jun 1, 2014 Accepting new patients

Locations

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1520 San Pablo St
Ste 1000
Los Angeles, CA 90033
Phone (626) 457-5839

Organizations & group practices 2

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1740481639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST",
            "address_2": "SUITE 1000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335310",
            "telephone_number": "323-442-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALVILLO KING",
        "first_name": "LINDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10022633",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C130419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTITUTIONAL PERMIT",
            "identifier": "BP1-0022633",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.