NPIMap

Organization Active NPI

White Memorial Gynecological and Obstetrical Medical Group

  • Obstetrics & Gynecology Physician
  • Los Angeles, CA
National Provider Identifier
1811060262
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25701525 Issued in CA
Legal business name
WHITE MEMORIAL GYNECOLOGICAL AND OBSTETRICAL MEDICAL GROUP
Practice address
1701 E Cesar E Chavez Ave
Suites 200/225
Los Angeles, CA 90033-2464
Phone
(323) 225-4300
Fax
(323) 225-1803
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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

Authorized official

Name
Dr. E. Laurence Spencer-Smith, MD
Title
Managing Partner
Phone
(323) 225-4300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 25701525 CA Primary

Addresses

Primary practice location

1701 E Cesar E Chavez Ave
Suites 200/225
Los Angeles, CA 90033-2464

Mailing address

1701 E Cesar E Chavez Ave
Suites 200/225
Los Angeles, CA 90033-2464
Phone (323) 225-4300

Other identifiers 2

IdentifierTypeStateIssuer
1811060262OtherCANPI
ZZZ76811ZMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090501000330 CA Part B Supplier - Clinic/Group Practice 2062560907 Receives reassigned benefits from 14 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

1701 E Cesar E Chavez Ave
Ste 200225
Los Angeles, CA 90033
Phone (323) 225-4300

1247 Wilshire Blvd Ste 580
Los Angeles, CA 90017

1701 E Cesar E Chavez Ave
Ste 20
Los Angeles, CA 90033

1701 E Cesar E Chavez Ave
Ste 22
Los Angeles, CA 90033

1701 E Cesar E Chavez Ave
#200225
Los Angeles, CA 90033
Phone (323) 225-4300

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492992000000",
    "number": "1811060262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 E CESAR E CHAVEZ AVE",
            "address_2": "SUITES 200/225",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332464",
            "telephone_number": "323-225-4300",
            "fax_number": "323-225-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E CESAR E CHAVEZ AVE",
            "address_2": "SUITES 200/225",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332464",
            "telephone_number": "323-225-4300",
            "fax_number": "323-225-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE MEMORIAL GYNECOLOGICAL AND OBSTETRICAL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2017-04-24",
        "status": "A",
        "authorized_official_last_name": "SPENCER-SMITH",
        "authorized_official_first_name": "E.  LAURENCE",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "323-225-4300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "25701525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1811060262",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ76811Z",
            "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 Apr 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.