David L Davis-Boozer, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A191430 Issued in CA

Practice address

5100 W Goldleaf Cir Ste 200
Los Angeles, CA 90056-1271

Phone

(323) 293-7171

NPI assigned

Aug 14, 2013

Last updated

May 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• David Lee Boozer Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OR, CA2 enrollments

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 2

Specialty

Family Practice

Education

Oregon Health Sciences University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Home Health la County South Home health agency, Torrance, CA, CCN 557447
• Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Medical Institute

  dba Providence Little Company of Mary Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1417915760
  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Oregon

  dba Providence St Vincent Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Medicare reassignment NPD
• Providence Medical Institute

  dba Providence Little Company of Mary Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1235182569
  NPD
• Providence Medical Institute

  dba Providence Little Company of Mary Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1760425862
  NPD
• Providence Health & Services - Oregon

  dba Prov St. Vincent Medical Ctr

  • Clinical Pathology Physician
  • Portland, OR
  • NPI 1831641745

  Family Medicine

  NPD
• Providence Health & Services - Oregon

  dba Providence St. Vincent Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Portland, OR
  • NPI 1285717728
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health System - Southern California

  dba Povidence Home Health la County South

  • Home Health Agency
  • Torrance, CA
  • NPI 1700890514
  Care Compare affiliation
• Providence Health System Southern California

  dba Providence Little Company of Mary Medical Center Torrance

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1902844988
  Care Compare affiliation

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1912330861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W GOLDLEAF CIR STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900561271",
            "telephone_number": "323-293-7171",
            "fax_number": "310-348-3716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W GOLDLEAF CIR STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900561271",
            "telephone_number": "323-293-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS-BOOZER",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-14",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A191430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dboozer1109598@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "29345 SW Town Center Loop E Ste 110",
            "city": "Wilsonville",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970708486",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dboozer1109598@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9205 SW Barnes Rd",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "BOOZER",
            "middle_name": "LEE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vivian Davila
• Lizette Davillier, LCSW
• John Baptiste Davilmar, MD
• Linda Davine
• Davis Famili DDS Magd Inc
• Sophie Sarah Davis-Cohen, LCSW
• Rosalie A Davis-Green, MSW, LCSW
• Jessie Davis-Lee
• Julia Davis-Porada, MD, PHD
• Cherryl Lavonne Davis-Watson

• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.