Individual provider Active NPI

Kelly L Callahan, MD

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1932399631
Registry record updated Feb 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A98476 Issued in CA
Practice address
4650 W Sunset Blvd
Ms#76
Los Angeles, CA 90027-6062
Phone
(323) 361-2100
Fax
(323) 361-8566
NPI assigned
Jul 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A98476 CA Primary

Addresses

Primary practice location

4650 W Sunset Blvd
Ms#76
Los Angeles, CA 90027-6062

Mailing address

6430 W Sunset Blvd
600
Los Angeles, CA 90028-7901
Phone (323) 361-2337

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
I20090320000305 CA Practitioner - Pediatric Medicine 9436216355 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Aug 1, 2010 Accepting new patients
County of Los Angeles CurrentSince Aug 1, 2010 Accepting new patients
Children's Hospital Los Angeles Medical Group, Inc. Pediatrics Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

1000 W Carson St
#480
Torrance, CA 90502
Phone (310) 222-5026

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": "1185580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234310400000",
    "number": "1932399631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6430 W SUNSET BLVD",
            "address_2": "600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287901",
            "telephone_number": "323-361-2337",
            "fax_number": "323-361-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "address_2": "MS#76",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-2100",
            "fax_number": "323-361-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "KELLY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-28",
        "last_updated": "2009-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A98476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.