Citizens Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G29636 Issued in CA

Legal business name

CITIZENS MEDICAL GROUP

Practice address

11560 W. Pico Blvd
West Los Angeles, CA 90064

Phone

(310) 477-8285

Fax

(310) 477-9642

NPI assigned

Apr 16, 2008

Organization subpart

No

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

Authorized official

Name

Larry Brandis

Title

Doctor

Phone

(310) 477-8285

Specialties & licenses 1

Addresses

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Citizens Medical Group

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1831279884
  NPPES parent name

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1851565337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11560 W. PICO BLVD",
            "city": "WEST LOS ANGELES",
            "state": "CA",
            "postal_code": "90064",
            "telephone_number": "310-477-8285",
            "fax_number": "310-477-9642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11560 W. PICO BLVD",
            "city": "WEST LOS ANGELES",
            "state": "CA",
            "postal_code": "90064",
            "telephone_number": "310-477-8285",
            "fax_number": "310-477-9642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITIZENS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-16",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "BRANDIS",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "310-477-8285"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G29636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Berlin, PSY.D.
• Steve H Bolur, DDS
• Robert Boress, M.A., LMFT
• Bon Hoan Cho, L.AC.
• Kimberlee Chronister, PSYD
• Michelle Cohen, PH.D.
• Allan J. Comeau, PH.D.
• Shelby Rose Condon
• Bianca M Daalder, MFT
• Stephanie Mitsuye Dacay, R.D.

• Internal Medicine Physician in West Los Angeles, CA
• Providers in West Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; 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.