UNIVERSITY CHILDRENS MEDICAL GROUP (NPI# 1104024744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104024744 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY CHILDRENS MEDICAL GROUP |
| Practice Address |
4650 W Sunset Blvd Los Angeles CA 90027-6062 |
| Mailing Address |
6430 W Sunset Blvd Suite 600 Los Angeles CA 90028-7901 |
| Practice Telephone | 3236602450 |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARK SADAMITSU (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3236692109 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0000X |
Internal Medicine Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295910941 | University Childrens Medical Group | Physical Medicine & Rehabilitation | 4650 W Sunset Blvd # 5, Los Angeles, CA 90027-6062 | 2007-12-31 |
| 1790960441 | University Childrens Medical Group | Pathology | 4650 W Sunset Blvd # 43, Los Angeles, CA 90027-6062 | 2007-12-31 |
| 1669657318 | University Childrens Medical Group | Radiology | 4650 W Sunset Blvd # 81, Los Angeles, CA 90027-6062 | 2007-12-31 |
| 1932384682 | University Childrens Medical Group | Pediatrics | 4650 W Sunset Blvd # 83, Los Angeles, CA 90027-6062 | 2007-12-31 |
| 1073798716 | University Childrens Medical Group | Ophthalmology | 4650 W Sunset Blvd # 88, Los Angeles, CA 90027-6062 | 2007-12-31 |
| 1033394788 | University Childrens Medical Group | Plastic Surgery | 4650 W Sunset Blvd # 96, Los Angeles, CA 90027-6062 | 2007-12-31 |
| 1699950337 | University Childrens Medical Group | Neurological Surgery | 4650 W Sunset Blvd # 102, Los Angeles, CA 90027-6062 | 2007-12-31 |
| 1386829034 | University Childrens Medical Group | Urology | 4650 W Sunset Blvd # 114, Los Angeles, CA 90027-6062 | 2007-12-31 |
| 1114102860 | University Childrens Medical Group | Psychiatry & Neurology | 4650 W Sunset Blvd # 115, Los Angeles, CA 90027-6062 | 2007-12-31 |
| 1508041245 | University Childrens Medical Group | Optometrist | 4650 W Sunset Blvd # 88, Los Angeles, CA 90027-6062 | 2007-12-31 |
| Street Address |
4650 W SUNSET BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90027-6062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144223926 | Fariba Navid | Pediatrics | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2005-05-24 |
| 1811596810 | Samih Samaha | Social Worker | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2020-10-21 |
| 1437756988 | Amanda Ruth Mendelis | Nurse Practitioner | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2020-10-07 |
| 1124638119 | Hayden Mensah Mbroh | Rehabilitation Counselor | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2020-08-04 |
| 1619587854 | Allyssa Marie Asperin Cayago | Nurse Practitioner | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2020-08-03 |
| 1134739592 | Alison Coombs | Physical Therapist | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2020-07-31 |
| 1679190482 | Jearelly Pinedo | Registered Nurse | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2020-06-26 |
| 1124644901 | Corey Hacker | Nurse Practitioner | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2020-06-17 |
| 1720602667 | Bhavna Shah | Physical Therapist | 4650 W Sunset Blvd, Mailstop # 154, Los Angeles, CA 90027 | 2020-06-06 |
| 1023632528 | Bethany L Burdick | Student in an Organized Health Care Education/Training Program | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2020-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326653593 | Lamia Binhuwaishel | Student in an Organized Health Care Education/Training Program | 4650 Sunset Blvd, Craniofacial and Special Needs Ortho, Los Angeles, CA 90027 | 2020-09-14 |
| 1285242594 | Rocio Jimenez | Case Manager/Care Coordinator | 4650 Sunset Blvd, Mailstop #53, Los Angeles, CA 90027 | 2020-07-22 |
| 1558984799 | Integrative Endodontics, Inc | Dentist | 10850 Wilshine Blvd Ste 301, Los Angeles, CA 90027 | 2020-05-22 |
| 1104450295 | Sarayana Sercarz | Marriage & Family Therapist | 4080 Woking Way, Los Angeles, CA 90027 | 2020-02-27 |
| 1457991143 | George Michaiel | Pediatrics | 4650 Sunset Blvd., Ms #54, Los Angeles, CA 90027 | 2020-01-09 |
| 1477199297 | Molly Rose Holmes | Marriage & Family Therapist | 3901 Los Feliz Boulevard, #303, Los Angeles, CA 90027 | 2019-11-27 |
| 1588206171 | Dental Help Solutions, LLC | Dentist | 4606 Hollywood Blvd, Suite A, Los Angeles, CA 90027 | 2019-10-15 |
| 1457905986 | Carmen L Ponce | Physical Therapy Assistant | 4867 Sunset Ave, Los Angeles, CA 90027 | 2019-08-01 |
| 1447729009 | Matthew Mendoza | Respiratory Therapist, Registered | 4867 Sunset Blvd, Los Angeles, Ca, Los Angeles, CA 90027 | 2018-11-13 |
| 1659856284 | Leticia Mendez | Nurse Practitioner | 1300 N Vermont Ave 606, Los Angeles, CA 90027 | 2018-09-29 |
| Find all providers in zip 90027 | ||||
| Taxonomy Code | 207RA0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Adolescent Medicine |
| An internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982791562 | Rafayel Gevorkian | Internal Medicine | 5129 W Sunset Blvd, Los Angeles, CA 90027-5715 | 2006-10-06 |
| 1114249620 | Violeta M De Jesus Md | Internal Medicine | 2011 Wilshire Blvd, Los Angeles, CA 90057-3503 | 2010-02-25 |
| 1790946580 | Manel Silva | Internal Medicine | 2219 E 1st St, Los Angeles, CA 90033-3901 | 2008-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396115853 | Cedars Primary Care Apmc | Internal Medicine | 18370 Burbank Blvd Ste 201, Tarzana, CA 91356-2853 | 2015-09-28 |
| 1669886933 | Marius Viseroi | Internal Medicine | 3231 Waring Ct Ste D, Oceanside, CA 92056-4510 | 2014-06-16 |
| 1730314378 | Lofty L Basta | Internal Medicine | 765 Market St Apt 35a, San Francisco, CA 94103-2041 | 2009-05-27 |
| 1659534766 | Goodfaith Family Medical Clinic | Internal Medicine | 7540 Garvey Ave Ste C, Rosemead, CA 91770-2960 | 2008-07-08 |
| 1710109509 | Joshua A Jacobi | Internal Medicine | 301 S Fair Oaks Ave Ste 404, Pasadena, CA 91105-2562 | 2007-05-03 |
| 1972624955 | Innovative Medical Solutions Inc A Medical Group | Internal Medicine | 14860 Roscoe Blvd Ste 200, Panorama City, CA 91402-4683 | 2007-04-03 |
| 1326101445 | Karen K.w. Kakishiba, M.d. Inc. | Internal Medicine | 810 Richland Rd, Yuba City, CA 95991-6200 | 2006-12-19 |
| 1518030543 | Lisa Law | Internal Medicine | 728 Pacific Ave Ste 302, San Francisco, CA 94133-4489 | 2006-11-16 |
| 1497844864 | Shigeki Fujitani | Internal Medicine | 6170 Canterbury Dr, Apt 222, Culver City, CA 90230-7929 | 2006-10-12 |
| 1801988142 | Arturo Zarate Abalos | Internal Medicine | 1004 14th Ave, Delano, CA 93215 | 2006-09-28 |
| Find all providers with the same taxonomy | ||||
| City | LOS ANGELES |
| Zip Code | 90027 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.