Lifespring Medical Group

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

LIFESPRING MEDICAL GROUP

Practice address

710 S Central Ave Ste 310
Glendale, CA 91204-4641

Phone

(818) 396-5190

Fax

(818) 396-5197

NPI assigned

Feb 24, 2025

Organization subpart

No

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

Authorized official

Name

Adrienne Grant, DONPI 1063571834

Title

Medical Director

Phone

(818) 396-5190

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Adrienne Ann Grant, D.O.

  • General Practice Physician
  • Long Beach, CA
  • NPI 1063571834
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1821894288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 S CENTRAL AVE STE 310",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044641",
            "telephone_number": "818-396-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S CENTRAL AVE STE 310",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044641",
            "telephone_number": "818-396-5190",
            "fax_number": "818-396-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPRING MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "ADRIENNE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-396-5190",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Glendale, CA
• Providers in Glendale, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.