Organization Active NPI

Earl L Cherniak DPM a Prof Corp

  • Podiatrist
  • Los Angeles, CA
National Provider Identifier
1780746685
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E1180 Issued in CA
Legal business name
EARL L CHERNIAK DPM A PROF CORP
Practice address
3984 So Figueroa St
Los Angeles, CA 90037
Phone
(213) 747-7272
Fax
(310) 476-8003
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Authorized official

Name
Earl Lowell Cherniak, DPM
Title
President
Phone
(310) 476-5397

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X E1180 CA Primary

Addresses

Primary practice location

3984 So Figueroa St
Los Angeles, CA 90037

Mailing address

11724 Gwynne Lane
Los Angeles, CA 90077
Phone (310) 476-5397

Other identifiers 1

IdentifierTypeStateIssuer
000E11800MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1780746685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11724 GWYNNE LANE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90077",
            "telephone_number": "310-476-5397",
            "fax_number": "310-476-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3984 SO FIGUEROA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90037",
            "telephone_number": "213-747-7272",
            "fax_number": "310-476-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARL L CHERNIAK DPM A PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "CHERNIAK",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "LOWELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-476-5397",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E1180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E11800",
            "state": "CA"
        }
    ],
    "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 Mar 24, 2008; 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.