KPG California, LLC

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

53488 Issued in CA

Legal business name

KPG CALIFORNIA, LLC

Practice address

9000 W Sunset Blvd Ste 1500
West Hollywood, CA 90069-5815

Phone

(310) 975-1450

NPI assigned

Dec 10, 2015

Organization subpart

No

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

Authorized official

Name

Darryl Olivier

Title

Chief Operations Officer

Phone

(310) 975-1450

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449705600000",
    "number": "1841665254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W SUNSET BLVD STE 1500",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900695815",
            "telephone_number": "310-975-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W SUNSET BLVD STE 1500",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900695815",
            "telephone_number": "310-975-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KPG CALIFORNIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2015-12-10",
        "status": "A",
        "authorized_official_last_name": "OLIVIER",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "310-975-1450"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "CA",
            "license": "53488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction Medicine (Internal Medicine) Physician in West Hollywood, CA
• Providers in West Hollywood, CA by specialty
• Addiction Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.