Individual provider Active NPI

Pooja Gidwani

  • Internal Medicine Physician
  • West Hollywood, CA
National Provider Identifier
1881004398
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A185843 Issued in CA
Practice address
8605 Santa Monica Blvd
West Hollywood, CA 90069-4109
Phone
(713) 242-3768
NPI assigned
May 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R6402 TX
Internal Medicine Physician 207R00000X 55605 AZ
Hospitalist Physician 208M00000X R6402 TX
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X A185843 CA Primary

Addresses

Primary practice location

8605 Santa Monica Blvd
West Hollywood, CA 90069-4109

Mailing address

8605 Santa Monica Blvd
West Hollywood, CA 90069-4109
Phone (310) 902-8816

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
I20240424002906 CA Practitioner - Internal Medicine 9335417989 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A185843CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kansal Inc Internal Medicine CurrentSince Mar 10, 2024 Accepting new patients
Circle Medical Care of California Internal Medicine CurrentSince Aug 31, 2024 Accepting new patients
Hni Medical Services Internal Medicine PastSince Mar 1, 2020 Accepting new patients

Locations

415 N Crescent Dr
Ste 320
Beverly Hills, CA 90210
Phone (415) 510-2755

333 1st St
Ste A
San Francisco, CA 94105
Phone (312) 724-7441

1426 Montana Ave
Ste 2
Santa Monica, CA 90403
Phone (310) 388-6798

4650 Lincoln Blvd
Venice, CA 90292
Phone (310) 577-5505

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Organizations & group practices 3

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": "1399334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1881004398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8605 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694109",
            "telephone_number": "310-902-8816",
            "fax_number": "310-362-8452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8605 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694109",
            "telephone_number": "713-242-3768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIDWANI",
        "first_name": "POOJA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-06",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R6402",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "55605",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "R6402",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A185843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

Verify at the official NPI Registry.