UCLA DEPARTMENT OF PEDIATRIC GROUP PRACTICE (NPI# 1093025355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093025355 |
| Entity Type | Organization |
| Organization Name | UCLA DEPARTMENT OF PEDIATRIC GROUP PRACTICE |
| Practice Address |
200 Medical Plz Suite 265 Los Angeles CA 90095-0001 |
| Mailing Address |
10833 Le Conte Ave 22-474 Mdcc Los Angeles CA 90095-1752 |
| Practice Telephone | 3108250867 |
| Practice Fax Number | 3102065146 |
| Mailing Telephone | 3108256196 |
| Mailing Fax Number | 3108255834 |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2010-10-20 |
| Authorized Official Name | SHERIN DEVASKAR (INTERIM EXECUTIVE CHAIR) |
| Authorized Official Telephone | 3108255095 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0200X |
Registered Nurse Specialization: Pediatrics |
677319 | CA | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
19341 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
200 MEDICAL PLZ SUITE 265 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90095-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790789287 | Afshin Akhavan Safa | Radiology | 200 Medical Plz, Suite B265, Los Angeles, CA 90095-0001 | 2005-06-13 |
| 1700316239 | Andrew Scott | Pharmacy | 200 Medical Plz, Los Angeles, CA 90095-0001 | 2017-06-18 |
| 1861943037 | Rebecca Gebremichael | Audiologist | 200 Medical Plz, 540, Los Angeles, CA 90095-0001 | 2016-10-21 |
| 1649640707 | Mehdi Mohamadnejad | Internal Medicine | 200 Medical Plz, Suite 365 C, Los Angeles, CA 90095-0001 | 2015-10-01 |
| 1154799542 | Gerd Ken Herrmann | Nuclear Medicine | 200 Medical Plz, Suite B114, Los Angeles, CA 90095-0001 | 2015-09-02 |
| 1902291354 | Miranda Westfall | Dietitian, Registered | 200 Medical Plz, Suite 265, Los Angeles, CA 90095-0001 | 2015-04-02 |
| 1508255191 | Nicole Anne Schussel | Speech-Language Pathologist | 200 Medical Plz, Suite 540, Los Angeles, CA 90095-0001 | 2015-01-20 |
| 1821492414 | Sherly Cherian | Dietitian, Registered | 200 Medical Plz, Suite 530, Los Angeles, CA 90095-0001 | 2014-10-10 |
| 1548502644 | Lisa Kay Tritico | General Acute Care Hospital | 200 Medical Plz, Suite 660, Los Angeles, CA 90095-0001 | 2013-03-27 |
| 1184966210 | Ucla Health Systems | Clinic/Center | 200 Medical Plz, Suite 660, Los Angeles, CA 90095-0001 | 2013-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982212155 | Alexandra Gubin | Social Worker | Ucla, 757 Westwood Medical Plaza, Los Angeles, CA 90095 | 2020-07-14 |
| 1952926263 | Georgina Parra | Student in an Organized Health Care Education/Training Program | 10833 Le Conteave, Los Angeles, CA 90095 | 2020-06-11 |
| 1609403575 | Yagmur Muftuoglu | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza, Neurosurgery, Los Angeles, CA 90095 | 2020-03-23 |
| 1619438173 | Brandon Covington Smith | Student in an Organized Health Care Education/Training Program | 727 Westwood Plaza, Dept of Internal Medicine, Los Angeles, CA 90095 | 2019-03-27 |
| 1184184913 | Alexander Daniel Yuen | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza (internal Medicine), Los Angeles, CA 90095 | 2019-03-19 |
| 1790266369 | Dana Saifan | Student in an Organized Health Care Education/Training Program | 1000 Veteran Avenue, Los Angeles, CA 90095 | 2018-08-22 |
| 1427549146 | Courtney Renee' Real | Registered Nurse | 757 Westwood Plz Ste 6236, Los Angeles, CA 90095 | 2018-05-29 |
| 1932605094 | Akash Atul Shah | Student in an Organized Health Care Education/Training Program | Ucla Department of Orthopaedic Surgery, 10833 Le Conte Avenue, 76-116 Chs, Los Angeles, CA 90095 | 2018-04-05 |
| 1316443435 | Dane Jensen Brodke | Orthopaedic Surgery | 757 Westwood Plaza, (orthopaedic Surgery), Los Angeles, CA 90095 | 2018-04-05 |
| 1477058824 | Thomas William Gaither Castellanos | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza, Urology, Los Angeles, CA 90095 | 2018-03-28 |
| Find all providers in zip 90095 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962003640 | Samira Kadri | Nurse Practitioner | 431 S Burnside Ave Apt 3g, Los Angeles, CA 90036-5343 | 2020-11-08 |
| 1528672110 | Christopher Tria Coronel | Nurse Practitioner | 3435 Garden Ave, Los Angeles, CA 90039-1919 | 2020-09-01 |
| 1871119701 | Carina Lizette Guerra | Nurse Practitioner | St. John's Well Child and Family Center, Inc., 808 W. 58th Street, Los Angeles, CA 90037 | 2020-06-16 |
| 1548884216 | En Route Medical Staffing LLC | Nurse Practitioner | 3705 W Pico Blvd Ste 1714, Los Angeles, CA 90019-3451 | 2020-05-29 |
| 1922621432 | Latasha Tracy Warren | Nurse Practitioner | 1720 N Fuller Ave Apt 450, Los Angeles, CA 90046-3076 | 2020-05-19 |
| 1578184966 | Shin Il Kim | Nurse Practitioner | 450 Bauchet St Fl 8, Los Angeles, CA 90012-2907 | 2020-04-27 |
| 1457971160 | Karen Kim-chang | Nurse Practitioner | 450 Bauchet St Rm E815, Los Angeles, CA 90012-2907 | 2020-04-22 |
| 1912534033 | Anthony Felipe Banuelos Villa | Nurse Practitioner | 3437 Ellison St, Los Angeles, CA 90063-1901 | 2020-03-26 |
| 1629605506 | Ana Yely Nunez Nunez | Nurse Practitioner | 6017 Miramonte Blvd, Los Angeles, CA 90001-1327 | 2020-03-23 |
| 1154957769 | Maybel Deguzman Dumlao | Nurse Practitioner | 4371 Stewart Ave, Los Angeles, CA 90066-6133 | 2020-03-14 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90095 |
Please comment or provide details below to improve the information on UCLA DEPARTMENT OF PEDIATRIC GROUP PRACTICE.
| 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.