NPIMap

Individual provider Active NPI

Bala Venugopal, M.D.

  • Pediatrics Physician
  • Downey, CA
National Provider Identifier
1952352734
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A67362 Issued in CA
Practice address
11480 Brookshire Ave
Suite 204
Downey, CA 90241-5026
Phone
(562) 862-2775
Fax
(562) 904-8035
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 A67362 CA Primary

Addresses

Primary practice location

11480 Brookshire Ave
Suite 204
Downey, CA 90241-5026

Mailing address

75 Remittance Dr
Dept 6008
Chicago, IL 60675-6008
Phone (562) 282-1419

Other identifiers 1

IdentifierTypeStateIssuer
00A673620MedicaidCA

Other names 1

  • Balasubramanian Venugopal Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A67362CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary'S Health, Inc. Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients
University of California Irvine Past Accepting new patients
Bright Medical Associates, Inc. Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
Providence Health & Services - Wa Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1952352734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMITTANCE DR",
            "address_2": "DEPT 6008",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606756008",
            "telephone_number": "562-282-1419",
            "fax_number": "562-920-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11480 BROOKSHIRE AVE",
            "address_2": "SUITE 204",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902415026",
            "telephone_number": "562-862-2775",
            "fax_number": "562-904-8035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENUGOPAL",
        "first_name": "BALA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A67362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A673620",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BALASUBRAMANIAN",
            "last_name": "VENUGOPAL",
            "credential": "M.D,",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Downey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.