Organization Active NPI

Akpene Gbegnon MD, Inc

  • Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1992458608
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
AKPENE GBEGNON MD, INC
Practice address
6221 Wilshire Blvd Ste 404
Los Angeles, CA 90048-5224
Phone
(310) 433-8252
Fax
(310) 861-1904
NPI assigned
Feb 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Authorized official

Name
Dr. Akpene Gbegnon, MDNPI 1184941379
Title
President
Phone
(310) 433-8252

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 Primary

Addresses

Primary practice location

6221 Wilshire Blvd Ste 404
Los Angeles, CA 90048-5224

Mailing address

11209 National Blvd # 158
Los Angeles, CA 90064-3902
Phone (310) 433-8252

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230301000926 CA Part B Supplier - Clinic/Group Practice 2961875521 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

12021 Wilmington Ave
Ste 2200
Los Angeles, CA 90059
Phone (310) 433-8252

Practitioners & affiliated clinicians

Practitioners 1

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": "1643760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643760000000",
    "number": "1992458608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11209 NATIONAL BLVD # 158",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900643902",
            "telephone_number": "310-433-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 WILSHIRE BLVD STE 404",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485224",
            "telephone_number": "310-433-8252",
            "fax_number": "310-861-1904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AKPENE GBEGNON MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-02",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A",
        "authorized_official_last_name": "GBEGNON",
        "authorized_official_first_name": "AKPENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-433-8252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "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 Feb 2, 2022; 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.