Active NPI
Debra R Judelson, M.D.
- Cardiovascular Disease Physician
- Beverly Hills, CA
National Provider Identifier
1790757136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- G35161
- Practice address
- 414 N Camden Dr
Ste 1100
Beverly Hills, CA 90210-4532 - Phone
- (310) 278-3400
- Fax
- (310) 278-1240
- NPI assigned
- Feb 1, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | G35161 | CA | Primary |
Addresses
Primary practice location
414 N Camden Dr
Ste 1100
Beverly Hills, CA 90210-4532
Mailing address
414 N Camden Dr
Ste 1100
Beverly Hills, CA 90210-4532
Phone (310) 278-3400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G351610 | 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 |
|---|---|---|---|
| G35161 | CA | MD | Cardiovascular Disease Physician |
Interoperability endpoints
- djudelson102997@direct.cshs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260748800000",
"number": "1790757136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 N CAMDEN DR",
"address_2": "STE 1100",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902104532",
"telephone_number": "310-278-3400",
"fax_number": "310-278-1240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 N CAMDEN DR",
"address_2": "STE 1100",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902104532",
"telephone_number": "310-278-3400",
"fax_number": "310-278-1240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUDELSON",
"first_name": "DEBRA",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-01",
"last_updated": "2009-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "CA",
"license": "G35161",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G351610",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.