Active NPI
Christos Emmanouel Emmanouilides, MD
- Hematology & Oncology Physician
- Los Angeles, CA
National Provider Identifier
1780600619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- A50601
- Practice address
- 200 Medical Plaza
#365
Los Angeles, CA 90095-3075 - Phone
- (310) 825-0631
- NPI assigned
- Jul 14, 2006
- Last updated
- Jun 14, 2010
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | A50601 | CA | Primary |
Addresses
Primary practice location
200 Medical Plaza
#365
Los Angeles, CA 90095-3075
Mailing address
5767 W Century Blvd
Suite 200
Los Angeles, CA 90045-5632
Phone (310) 825-0631
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A506010 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A50601 | CA | MD | Hematology & Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276473600000",
"number": "1780600619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD",
"address_2": "SUITE 200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455632",
"telephone_number": "310-825-0631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MEDICAL PLAZA",
"address_2": "#365",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900953075",
"telephone_number": "310-825-0631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMMANOUILIDES",
"first_name": "CHRISTOS",
"middle_name": "EMMANOUEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-14",
"last_updated": "2010-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "CA",
"license": "A50601",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A506010",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
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- Vida Emmanuel
- Dana Lynn Emmer, MSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.