NPIMap

Organization Active NPI

Child Neurology of Beverly Hills, Inc

  • Neurology with Special Qualifications in Child Neurology Physician
  • Glendale, CA
National Provider Identifier
1770748261
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
A73193 Issued in CA
Legal business name
CHILD NEUROLOGY OF BEVERLY HILLS, INC
Practice address
501 W Glenoaks Blvd
# 705
Glendale, CA 91202-2896
Phone
(818) 788-7857
Fax
(818) 788-7857
NPI assigned
Jul 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Authorized official

Name
Dr. Michele Marie Van Hirtum-Das, M.D.
Title
President
Phone
(818) 788-7857

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0402X A73193 CA Primary
Medical Specialty Clinic/Center 261QM2500X A73193 CA

Addresses

Primary practice location

501 W Glenoaks Blvd
# 705
Glendale, CA 91202-2896

Mailing address

501 W Glenoaks Blvd
# 705
Glendale, CA 91202-2896
Phone (818) 788-7857

National Provider Directory

National Provider Directory
Tax ID family
Child Neurology of Beverly Hills2 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

501 W Glenoaks Blvd
#705
Glendale, CA 91202
Phone (818) 788-7857

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391990400000",
    "number": "1770748261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W GLENOAKS BLVD",
            "address_2": "# 705",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022896",
            "telephone_number": "818-788-7857",
            "fax_number": "818-788-7857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W GLENOAKS BLVD",
            "address_2": "# 705",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022896",
            "telephone_number": "818-788-7857",
            "fax_number": "818-788-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD NEUROLOGY OF BEVERLY HILLS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-23",
        "last_updated": "2014-02-10",
        "status": "A",
        "authorized_official_last_name": "VAN HIRTUM-DAS",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-788-7857",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CA",
            "license": "A73193",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A73193",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; 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.