La Brea Medical Clinic Pain Management, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G61506 Issued in CA

Legal business name

LA BREA MEDICAL CLINIC PAIN MANAGEMENT, INC

Practice address

3831 Hughes Ave
705
Culver City, CA 90232-2751

Phone

(310) 558-8600

Fax

(310) 558-8650

NPI assigned

Mar 25, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Leslie D. Paul, M.D.NPI 1366509499

Title

Owner

Phone

(310) 558-8600

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Leslie Diana Paul, M.D.

  • Internal Medicine Physician
  • Culver City, CA
  • NPI 1366509499
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269475200000",
    "number": "1871817460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3831 HUGHES AVE",
            "address_2": "705",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322751",
            "telephone_number": "310-558-8600",
            "fax_number": "310-558-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3831 HUGHES AVE",
            "address_2": "705",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322751",
            "telephone_number": "310-558-8600",
            "fax_number": "310-558-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA BREA MEDICAL CLINIC PAIN MANAGEMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-25",
        "last_updated": "2010-03-25",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-558-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G61506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OOG615060",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Kurzman, M.D.
• KW Management Enterprises, LLC
• Nana Kwarteng
• Zainura Kyshtobaeva
• L & a Care Corporation
• Alvaro Mauricio La Rosa
• La Vida Multi-Specialty Medical Group
• Noreen Ann Laberinto, MA, BCBA
• Lavenia Labregas
• Marie Labriola

• Internal Medicine Physician in Culver City, CA
• Providers in Culver City, 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 Mar 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.