LACY LITTLE KNOWLES


Address: 6801 Park Ter Ste 130, Los Angeles, CA 90045
Phone: 3102487878

LACY LITTLE KNOWLES (NPI# 1952660599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952660599
Entity Type Individual
Full Name LACY LITTLE KNOWLES
Credential D.O.
Practice Address 6801 Park Ter Ste 130
Los Angeles
CA 90045
Mailing Address Po Box 54679
Los Angeles
CA 90054-0679
Practice Telephone 3102487878
Practice Fax Number 3102487850
Enumeration Date 2012-05-15
Last Update Date 2019-12-09
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207QA0505X Family Medicine
Specialization: Adult Medicine
20A15521 CA Allopathic & Osteopathic Physicians
Y 207QS0010X Family Medicine
Specialization: Sports Medicine
20A15521 CA Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
3801 North Blvd, Baton Rouge, LA 708063825 2253877899 2253812579
6801 Park Ter Ste 130, Los Angeles, CA 90045 3102487878 3102487850

Office Location

Street Address 6801 PARK TER STE 130
City LOS ANGELES
State CA
Zip Code 90045

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Taxonomy Information

Taxonomy Code 207QS0010X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Sports Medicine

Taxonomy Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
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 Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine.

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City LOS ANGELES
Zip Code 90045

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Dataset Information

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.

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