Active NPI
Mark Buenaventura
- Community Health Worker
- Los Angeles, CA
National Provider Identifier
1801390281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 426 S San Pedro St
Los Angeles, CA 90013-2119 - Phone
- (323) 893-2909
- NPI assigned
- Mar 21, 2018
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | CA | Primary |
Addresses
Primary practice location
426 S San Pedro St
Los Angeles, CA 90013-2119
Mailing address
426 S San Pedro St
Los Angeles, CA 90013-2119
Phone (323) 893-2909
Other practice location 1
695 S Vermont Ave
Los Angeles, CA 90005-1349
Phone (323) 893-2909
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": "1521590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1801390281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "426 S SAN PEDRO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900132119",
"telephone_number": "323-893-2909"
},
{
"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": "323-893-2909"
}
],
"practiceLocations": [
{
"address_1": "695 S Vermont Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900051349",
"country_code": "US",
"telephone_number": "323-893-2909",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUENAVENTURA",
"first_name": "MARK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-21",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "CA",
"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 Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.