NPIMap

Organization Active NPI

California General Surgeons Medical Group Inc.

  • Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1992030944
Registry record updated Oct 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G31574 Issued in CA
Legal business name
CALIFORNIA GENERAL SURGEONS MEDICAL GROUP INC.
Practice address
1414 S Grand Ave
Suite 375
Los Angeles, CA 90015-3067
Phone
(213) 747-5211
NPI assigned
Oct 8, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2009

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

Authorized official

Name
Dr. Alan Weiss, M.D., F.A.C.SNPI 1669552402
Title
Surgeon, President
Phone
(213) 747-5211

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X G31574 CA Primary

Addresses

Primary practice location

1414 S Grand Ave
Suite 375
Los Angeles, CA 90015-3067

Mailing address

1414 S Grand Ave
Suite 375
Los Angeles, CA 90015-3067
Phone (213) 747-5211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100224000925 CA Part B Supplier - Clinic/Group Practice 0648314930 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory
Tax ID family
California General Surgeons Medical Group Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1414 S Grand Ave
Ste 375
Los Angeles, CA 90015
Phone (213) 746-3783

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256774400000",
    "number": "1992030944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 S GRAND AVE",
            "address_2": "SUITE 375",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153067",
            "telephone_number": "213-747-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 S GRAND AVE",
            "address_2": "SUITE 375",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153067",
            "telephone_number": "213-747-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA GENERAL SURGEONS MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-08",
        "last_updated": "2009-10-29",
        "status": "A",
        "authorized_official_last_name": "WEISS",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "SURGEON, PRESIDENT",
        "authorized_official_telephone_number": "213-747-5211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., F.A.C.S"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "G31574",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.