Individual provider Active NPI

Alvin Nyaboga, MD

  • Neurology Physician
  • Los Angeles, CA
National Provider Identifier
1982233813
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A194016 Issued in CA
Practice address
200 UCLA Medical PLZ Ste 265
Los Angeles, CA 90095-0001
Phone
(310) 825-0867
Fax
(310) 794-5066
NPI assigned
Apr 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A194016 CA Primary

Addresses

Primary practice location

200 UCLA Medical PLZ Ste 265
Los Angeles, CA 90095-0001

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240508001397 CA Practitioner - Neurology 0446691448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Rutgers New Jersey Medical School, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631

Hospital & facility affiliations

  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A194016CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents CurrentSince Jul 1, 2024 Accepting new patients
UCLA Medical Group Neurology Past Accepting new patients

Locations

200 UCLA Medical Plz
Ste 265
Los Angeles, CA 90095
Phone (310) 206-2429

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

10833 Le Conte Ave
#12311
Los Angeles, CA 90095
Phone (310) 825-9124

892 Aerovista Pl
Ste 210
San Luis Obispo, CA 93401
Phone (805) 549-8023

1260 15th St
Ste 1024
Santa Monica, CA 90404
Phone (424) 259-8570

215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435

Interoperability endpoints

  • Direct secure messaging: anyaboga1267991@direct.uclahealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1982233813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLZ STE 265",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-825-0867",
            "fax_number": "310-794-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYABOGA",
        "first_name": "ALVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A194016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.