NPIMap

Organization Active NPI

La Vida Multispecialty Medical Group Inc

  • Specialist
  • Hawthorne, CA
National Provider Identifier
1861522708
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
22234 Issued in CA
Legal business name
LA VIDA MULTISPECIALTY MEDICAL GROUP INC
Practice address
4455 W 117TH St
Hawthorne, CA 90250-2241
Phone
(310) 214-8677
Fax
(310) 921-1718
NPI assigned
Mar 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Christopher C Chidi, MD
Title
President
Phone
(310) 214-8677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 22234 CA Primary

Addresses

Primary practice location

4455 W 117TH St
Hawthorne, CA 90250-2241

Mailing address

Department 2834
Los Angeles, CA 90084
Phone (310) 214-8677

National Provider Directory

National Provider Directory
Tax ID family
La Vida Multi-Specialty Medical Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4455 W 117th St
Hawthorne, CA 90250
Phone (310) 645-0444

Dept 2834
Los Angeles, CA 90084

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861522708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT 2834",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90084",
            "telephone_number": "310-214-8677",
            "fax_number": "310-921-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 W 117TH ST",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902502241",
            "telephone_number": "310-214-8677",
            "fax_number": "310-921-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA VIDA MULTISPECIALTY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHIDI",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-214-8677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "22234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.