Uti-Ehrlich Medical Group

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

G14024 Issued in CA

Legal business name

UTI-EHRLICH MEDICAL GROUP

Practice address

100 UCLA Medical PLZ
Suite 690
Los Angeles, CA 90095-0001

Phone

(310) 825-6865

Fax

(310) 206-6600

NPI assigned

Apr 6, 2007

Last updated

Jul 18, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Judie Garnett

Title

Manager

Phone

(310) 825-6865

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1780707737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 UCLA MEDICAL PLZ",
            "address_2": "SUITE 690",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-825-6865",
            "fax_number": "310-206-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 UCLA MEDICAL PLZ",
            "address_2": "SUITE 690",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-825-6865",
            "fax_number": "310-206-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTI-EHRLICH MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "GARNETT",
        "authorized_official_first_name": "JUDIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "310-825-6865"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "G14024",
            "primary": true
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "CA",
            "license": "G14024",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D0962904",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; 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.