NPIMap

Organization Active NPI

White Memorial Medical Group, Inc.

  • Podiatrist
  • Los Angeles, CA
National Provider Identifier
1902055866
Registry record updated Aug 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3598 Issued in CA
Legal business name
WHITE MEMORIAL MEDICAL GROUP, INC.
Practice address
1701 E Cesar E Chavez Ave
Suite 510
Los Angeles, CA 90033-2464
Phone
(323) 987-1362
Fax
(323) 987-1365
NPI assigned
Sep 16, 2008
Last updated
Aug 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2017

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

Authorized official

Name
Dr. Alan C. K. Lau, M.D.NPI 1396768446
Title
President
Phone
(323) 987-1362

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X E3598 CA Primary
Durable Medical Equipment & Medical Supplies 332B00000X E3598 CA

Addresses

Primary practice location

1701 E Cesar E Chavez Ave
Suite 510
Los Angeles, CA 90033-2464

Mailing address

PO Box 51741
Los Angeles, CA 90051-6041
Phone (323) 987-1362

Other identifiers 2

IdentifierTypeStateIssuer
GRE001650MedicaidCA
CR0076OtherRR MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502323200000",
    "number": "1902055866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51741",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900516041",
            "telephone_number": "323-987-1362",
            "fax_number": "323-987-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E CESAR E CHAVEZ AVE",
            "address_2": "SUITE 510",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332464",
            "telephone_number": "323-987-1362",
            "fax_number": "323-987-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE MEMORIAL MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-16",
        "last_updated": "2017-08-10",
        "status": "A",
        "authorized_official_last_name": "LAU",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "C. K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-987-1362",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3598",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "E3598",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GRE001650",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CR0076",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2017; 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.