Individual provider Active NPI

Sumala Lopansri

  • Dermatology Physician
  • Monterey Park, CA
National Provider Identifier
1962574426
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A33915 Issued in CA
Practice address
223 N Garfield Ave
Suite 306
Monterey Park, CA 91754-1700
Phone
(626) 573-5005
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A33915 CA Primary

Addresses

Primary practice location

223 N Garfield Ave
Suite 306
Monterey Park, CA 91754-1700

Mailing address

223 N Garfield Ave
Suite 306
Monterey Park, CA 91754-1700
Phone (626) 573-5005

Other identifiers 2

IdentifierTypeStateIssuer
WA 33915BOtherCAMEDICARE PROVIDER NUMBER
GR0008161OtherCAMEDICAL PROVIDER NUMBER

Other names 1

  • Sumala Lo Other name

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
I20101206000325 CA Practitioner - DermatologyPractitioner - Other (Physician) 3678760535 Practice locations: Monterey Park, CA

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

223 N Garfield Ave
Monterey Park, CA 91754-1700
Phone (626) 573-5005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33915CAMDLicensed Psychiatric Technician
A33915CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ahmc Garfield Medical Center LP Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200614400000",
    "number": "1962574426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 N GARFIELD AVE",
            "address_2": "SUITE 306",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541700",
            "telephone_number": "626-573-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 N GARFIELD AVE",
            "address_2": "SUITE 306",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541700",
            "telephone_number": "626-573-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPANSRI",
        "first_name": "SUMALA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A33915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "WA 33915B",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PROVIDER NUMBER",
            "identifier": "GR0008161",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUMALA",
            "last_name": "LO",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Monterey Park, CA

Sources for this page

Verify at the official NPI Registry.