UNIVERSITY CHILDRENS MEDICAL GROUP (NPI# 1922206572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922206572 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY CHILDRENS MEDICAL GROUP |
| Practice Address |
4650 W Sunset Blvd Ms# 90 Los Angeles CA 90027-6062 |
| Mailing Address |
6430 W Sunset Blvd Suite 600 Los Angeles CA 90028-7901 |
| Practice Telephone | 3233614174 |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2012-10-18 |
| Authorized Official Name | MARK SADAMITSU (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3233612453 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR006667C | 05 |
| 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 MS# 90 |
| 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 | 207SG0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Medical Genetics |
| Specialization | Clinical Genetics (M.D.) |
| A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Medical Genetics, 2007. http://www.abmg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Medical Genetics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164541181 | Matthew Deardorff | Medical Genetics | 4650 W Sunset Blvd # Ms 43, Los Angeles, CA 90027-6062 | 2007-03-29 |
| 1770618589 | Linda S Cowan | Medical Genetics | 1111 W 6th St Fl 2, Los Angeles, CA 90017-1800 | 2007-02-22 |
| 1134199946 | Derek Alan Wong | Medical Genetics | 10833 Leconte Ave, Mdcc 12-334, Los Angeles, CA 90095-1732 | 2006-01-24 |
| 1568449122 | Shirley Rachel Korula | Medical Genetics | 4339 State University Dr, Diagnostic Center of Southern California, Los Angeles, CA 90032-4220 | 2005-12-27 |
| 1760765226 | Eyal M Reinstein | Medical Genetics | 8700 Beverly Blvd, Cedars Sinai Medical Center, Pact, Suite 400, Los Angeles, CA 90048 | 2011-09-21 |
| 1548548548 | Brandon Ross Colby | Medical Genetics | 10780 Santa Monica Blvd, Suite 360, Los Angeles, CA 90025-4749 | 2011-07-26 |
| 1922305036 | Linda S. Cowan, Md A Professional Corporation | Medical Genetics | 637 Lucas Ave, #205, Los Angeles, CA 90017-1912 | 2011-02-25 |
| 1306076039 | Alvaro H Serrano Russi | Medical Genetics | 4650 Sunset Blvd, Los Angeles, CA 90027-6062 | 2009-07-15 |
| 1962688853 | Sridevi Abboy | Medical Genetics | 4760 W Sunset Blvd, Los Angeles, CA 90027-6063 | 2008-01-10 |
| 1891995122 | Moin U Vera | Medical Genetics | 4650 W Sunset Blvd, Los Angeles, CA 90027 | 2007-07-24 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90027 |
Please comment or provide details below to improve the information on UNIVERSITY CHILDRENS MEDICAL GROUP.
| 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.