Individual provider Active NPI

John R Hubanks, MD

  • Otolaryngology Physician
  • La Canada, CA
National Provider Identifier
1811996697
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G10884 Issued in CA
Practice address
1370 Foothill Blvd
#100
La Canada, CA 91011-2150
Phone
(818) 952-1155
Fax
(818) 952-2632
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X G10884 CA Primary

Addresses

Primary practice location

1370 Foothill Blvd
#100
La Canada, CA 91011-2150

Mailing address

1370 Foothill Blvd
#100
La Canada, CA 91011-2150
Phone (818) 952-1155

Other identifiers 1

IdentifierTypeStateIssuer
040001519OtherCARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120427000409 CA Practitioner - Otolaryngology 0648432294 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G10884CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc Otolaryngology CurrentSince Feb 1, 2015 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Feb 1, 2015 Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients
Keck Medical Center of Usc Past Accepting new patients
Dignity Health Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients

Locations

222 W Eulalia St
Ste 200
Glendale, CA 91204
Phone (818) 291-4010

800 S Central Ave
Ste 204
Glendale, CA 91204
Phone (818) 240-8001

1370 Foothill Blvd
Ste 100
La Canada Flt, CA 91011
Phone (818) 649-3919

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1811996697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 FOOTHILL BLVD",
            "address_2": "#100",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "910112150",
            "telephone_number": "818-952-1155",
            "fax_number": "818-952-2632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 FOOTHILL BLVD",
            "address_2": "#100",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "910112150",
            "telephone_number": "818-952-1155",
            "fax_number": "818-952-2632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBANKS",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G10884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "040001519",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Canada, CA

Sources for this page

Verify at the official NPI Registry.