Individual provider Active NPI

Pamela R Kushner, M.D.

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1871670828
Registry record updated Jul 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G53239 Issued in CA
Practice address
1100 S Hope St
Suite 915
Los Angeles, CA 90015-2181
Phone
(562) 528-9792
Fax
(847) 241-8424
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G53239 CA Primary

Addresses

Primary practice location

1100 S Hope St
Suite 915
Los Angeles, CA 90015-2181

Mailing address

1100 S Hope St
Suite 915
Los Angeles, CA 90015-2181
Phone (562) 528-9792

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
I20111121000939 CA Practitioner - Family Practice 6800088782 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G53239CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California Irvine CurrentSince May 15, 2014 Accepting new patients
University of California Irvine CurrentSince May 15, 2014 Accepting new patients
Regents of the University of Family Medicine CurrentSince Jan 18, 2014 Accepting new patients
University of California Irvine Past Accepting new patients
NPI 1366540353 Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

300 W Carl Karcher Way
Anaheim, CA 92801
Phone (657) 282-6356

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

800 N Main St
Santa Ana, CA 92701
Phone (714) 456-6324

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469750400000",
    "number": "1871670828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S HOPE ST",
            "address_2": "SUITE 915",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900152181",
            "telephone_number": "562-528-9792",
            "fax_number": "847-241-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S HOPE ST",
            "address_2": "SUITE 915",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900152181",
            "telephone_number": "562-528-9792",
            "fax_number": "847-241-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSHNER",
        "first_name": "PAMELA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2016-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G53239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.