Benilda Buenaventura Obasohan, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

33569 Issued in CA

Practice address

1526 N Edgemont St
Los Angeles, CA 90027-5260

Phone

(323) 783-8070

Fax

(323) 783-5803

NPI assigned

Dec 7, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1871776229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 N EDGEMONT ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90027",
            "telephone_number": "323-783-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 N EDGEMONT ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275260",
            "telephone_number": "323-783-8070",
            "fax_number": "323-783-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBASOHAN",
        "first_name": "BENILDA",
        "middle_name": "BUENAVENTURA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-07",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "33569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4760 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Maria Venus Membrere Obando, D.D.S.
• Osagie Obanor
• Carmen Obasi
• Hannah Obasi
• Lisa Ugoma Obasi, MD
• Courtney Obasohan
• Fern Miyoko Obatake-Chang, PHD
• Florence Ovensei Obazee
• Jay Robert Malaluan Obciana
• Dina Obed

• Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.