Organization Active NPI

Los Angeles Ear, Nose & Throat Associates

  • Otolaryngology Physician
  • Los Angeles, CA
National Provider Identifier
1952349490
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
LOS ANGELES EAR, NOSE & THROAT ASSOCIATES
Practice address
1245 Wilshire Blvd
Suite 603
Los Angeles, CA 90017-4810
Phone
(213) 977-1215
Fax
(213) 977-0404
NPI assigned
Jun 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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

Authorized official

Name
Richard W Clark, M.D.
Title
Partner
Phone
(213) 977-1215

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

1245 Wilshire Blvd
Suite 603
Los Angeles, CA 90017-4810

Mailing address

1245 Wilshire Blvd
Suite 603
Los Angeles, CA 90017-4810
Phone (213) 977-1215

Other identifiers 1

IdentifierTypeStateIssuer
GR0071560MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309910400000",
    "number": "1952349490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD",
            "address_2": "SUITE 603",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174810",
            "telephone_number": "213-977-1215",
            "fax_number": "213-977-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD",
            "address_2": "SUITE 603",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174810",
            "telephone_number": "213-977-1215",
            "fax_number": "213-977-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES EAR, NOSE & THROAT ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2011-07-06",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "213-977-1215",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0071560",
            "state": "CA"
        }
    ],
    "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 Jul 6, 2011; 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.