Usc Ppa, Inc.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY5097 Issued in CA

Legal business name

USC PPA, INC.

Practice address

1520 San Pablo St
Ste 4100
Los Angeles, CA 90033-5316

Phone

(323) 442-6000

Fax

(323) 442-6001

NPI assigned

May 24, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Suresh Bangara, M.D.

Title

C.E.O.

Phone

(323) 442-6000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891798765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST",
            "address_2": "STE 4100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335316",
            "telephone_number": "323-442-6000",
            "fax_number": "323-442-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST",
            "address_2": "STE 4100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335316",
            "telephone_number": "323-442-6000",
            "fax_number": "323-442-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USC PPA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BANGARA",
        "authorized_official_first_name": "SURESH",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "323-442-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY5097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.