Individual provider Active NPI

John Azubike Uyanne, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Los Angeles, CA
National Provider Identifier
1871635243
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
A70516 Issued in CA
Practice address
8110 Airport Blvd
Los Angeles, CA 90045
Phone
(562) 706-2612
Fax
(562) 802-7978
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X A70516 CA Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 9217 NV

Addresses

Primary practice location

8110 Airport Blvd
Los Angeles, CA 90045

Mailing address

PO Box 985 Artesia Ca 90702
Artesia, CA 90702
Phone (562) 706-2612

Other identifiers 1

IdentifierTypeStateIssuer
00A705160MedicaidCA

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
I20120224000776 CA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 7911165725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1670 E 120TH St
Los Angeles, CA 90059-3026

Hospital & facility affiliations

  • Preferred Choice Home Health Care, Inc Home health agency, Reseda, CA, CCN 559037
  • Lac/Harbor-UCLA Med Center Hospital, Torrance, CA, CCN 050376

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A70516CAMDGeriatric Medicine (Internal Medicine) Physician
9217NVMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Jun 2, 2015 Accepting new patients
County of Los Angeles CurrentSince Jun 2, 2015 Accepting new patients

Locations

1000 S Fremont Ave
Bldg A11
Alhambra, CA 91803
Phone (626) 457-4240

12021 Wilmington Ave
Rm 1059
Los Angeles, CA 90059
Phone (310) 668-5201

1670 E 120th St
Los Angeles, CA 90059
Phone (424) 338-1000

12021 Wilmington Ave
Los Angeles, CA 90059
Phone (310) 668-4515

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871635243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 985 ARTESIA CA 90702",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "90702",
            "telephone_number": "562-706-2612",
            "fax_number": "562-802-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 AIRPORT BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90045",
            "telephone_number": "562-706-2612",
            "fax_number": "562-802-7978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UYANNE",
        "first_name": "JOHN",
        "middle_name": "AZUBIKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A70516",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NV",
            "license": "9217",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A705160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.