Active NPI
Ethan Cvitanic
- Student in an Organized Health Care Education/Training Program
- Los Angeles, CA
National Provider Identifier
1780504183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 426 S San Pedro St
Los Angeles, CA 90013-2119 - Phone
- (213) 626-6411
- NPI assigned
- Jul 16, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
426 S San Pedro St
Los Angeles, CA 90013-2119
Mailing address
12070 Telegraph Rd
Santa Fe Springs, CA 90670-3771
Phone (562) 777-7500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1784160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784160000000",
"number": "1780504183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12070 TELEGRAPH RD",
"city": "SANTA FE SPRINGS",
"state": "CA",
"postal_code": "906703771",
"telephone_number": "562-777-7500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "426 S SAN PEDRO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900132119",
"telephone_number": "213-626-6411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CVITANIC",
"first_name": "ETHAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-07-16",
"last_updated": "2026-07-16",
"certification_date": "2026-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Jul 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.