Individual provider Active NPI

Benjamin Wolfe Kleinbrodt, D.C.

  • Sports Physician Chiropractor
  • Los Angeles, CA
National Provider Identifier
1801993969
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
DC27789 Issued in CA
Practice address
11620 Wilshire Blvd
Ste 710
Los Angeles, CA 90025-1781
Phone
(310) 826-0721
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X DC27789 CA Primary

Addresses

Primary practice location

11620 Wilshire Blvd
Ste 710
Los Angeles, CA 90025-1781

Mailing address

11620 Wilshire Blvd
Ste 710
Los Angeles, CA 90025-1781
Phone (310) 826-0721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120130000066 CA Practitioner - Chiropractic 0648437970 Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11620 Wilshire Blvd
Los Angeles, CA 90025-1781
Phone (310) 826-0721

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC27789CAMDSports Physician Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1801993969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11620 WILSHIRE BLVD",
            "address_2": "STE 710",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251781",
            "telephone_number": "310-826-0721",
            "fax_number": "310-826-9894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11620 WILSHIRE BLVD",
            "address_2": "STE 710",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251781",
            "telephone_number": "310-826-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEINBRODT",
        "first_name": "BENJAMIN",
        "middle_name": "WOLFE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC27789",
            "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 Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.