Individual provider Active NPI

Phani Madhav Tumu, M.D.

  • Psychiatry Physician
  • Santa Monica, CA
National Provider Identifier
1811104805
Registry record updated Jan 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A89555 Issued in CA
Practice address
2633 Lincoln Blvd # 150
Santa Monica, CA 90405-4619
Phone
(310) 571-5597
NPI assigned
May 17, 2007
Last updated
Jan 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A89555 CA Primary

Addresses

Primary practice location

2633 Lincoln Blvd # 150
Santa Monica, CA 90405-4619

Mailing address

2633 Lincoln Blvd # 150
Santa Monica, CA 90405-4619

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

LicenseStateTypeSpecialty
A89555CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389916800000",
    "number": "1811104805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2633 LINCOLN BLVD # 150",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904054619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 LINCOLN BLVD # 150",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904054619",
            "telephone_number": "310-571-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUMU",
        "first_name": "PHANI",
        "middle_name": "MADHAV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2014-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A89555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2014; 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.