MARK DEANTONIO (NPI# 1578670444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578670444 |
| Entity Type | Individual |
| Full Name | MARK DEANTONIO |
| Practice Address |
300 Medical Plz Los Angeles CA 90095-0001 |
| Mailing Address |
5767 W Century Blvd Suite 400 Los Angeles CA 90045-5631 |
| Practice Telephone | 3108259989 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2011-08-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
G55591 | CA | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
G55591 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G555910 | 05 |
| Street Address |
300 MEDICAL PLZ |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90095-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487185039 | Ucla Mattel Children's Hospital | Clinic/Center | 300 Medical Plz, 3300, Los Angeles, CA 90095-0001 | 2017-03-24 |
| 1326493842 | Paola Suarez | Psychiatry & Neurology | 300 Medical Plz, Los Angeles, CA 90095-0001 | 2016-05-03 |
| 1043626377 | Susan Vereb | Physical Therapist | 300 Medical Plz, Suite B200, Los Angeles, CA 90095-0001 | 2014-07-08 |
| 1962752006 | Emma Billingslea-yoon | Nurse Practitioner | 300 Medical Plz, Suite 200, Los Angeles, CA 90095-0001 | 2012-09-17 |
| 1639458557 | Charles Jay Furst | Psychologist | 300 Medical Plz, Los Angeles, CA 90095-0001 | 2011-08-09 |
| 1457648446 | Maria Etchepare | Registered Nurse | 300 Medical Plz, Suite 200, Los Angeles, CA 90095-0001 | 2011-06-29 |
| 1114154861 | Jennifer Lynn Kruse | Psychiatry & Neurology | 300 Medical Plz, Rm 2273, Los Angeles, CA 90095-6968 | 2009-06-19 |
| 1457596272 | Scott C. Fears | Psychiatry & Neurology | 300 Medical Plz, Suite 2339, Los Angeles, CA 90095-0001 | 2008-12-08 |
| 1144484999 | Nicholas James Parziale | Psychiatry & Neurology | 300 Medical Plz, Suite B-200, Los Angeles, CA 90095-0001 | 2008-07-10 |
| 1235391418 | Indranil Sen-gupta | Psychiatry & Neurology | 300 Medical Plz, Suite B200, Los Angeles, CA 90095-0001 | 2008-06-27 |
| 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 | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912432055 | Centered Health LLC | Psychiatry & Neurology | 6422 W 6th St, Los Angeles, CA 90048-4714 | 2017-04-26 |
| 1225302755 | Joseph Naylor Kenan | Psychiatry & Neurology | 12424 Wilshire Blvd Ste 1130, Los Angeles, CA 90025-1064 | 2012-03-01 |
| 1962786947 | Shirah Vollmer | Psychiatry & Neurology | 941 Westwood Blvd Ste 204, Los Angeles, CA 90024-2940 | 2011-10-07 |
| 1639469489 | Daniel J Siegel | Psychiatry & Neurology | 11980 San Vicente Blvd Ste 809, Los Angeles, CA 90049-6606 | 2011-04-13 |
| 1689800690 | Le Tran Notarfrancesco | Psychiatry & Neurology | 4700 W Sunset Blvd Fl 5, Los Angeles, CA 90027-6082 | 2009-06-04 |
| 1942479688 | Sharon O'neil | Psychiatry & Neurology | 4650 W Sunset Blvd # Ms 354, Los Angeles, CA 90027-6062 | 2008-02-27 |
| 1295946465 | Carolanne Kelly Phelan | Psychiatry & Neurology | 12424 Wilshire Blvd # 1010, Los Angeles, CA 90025-1052 | 2007-05-26 |
| 1477761310 | Lauren Burr Ozbolt | Psychiatry & Neurology | 12301 Wilshire Blvd Ste 202, Los Angeles, CA 90025-1023 | 2007-05-21 |
| 1841415544 | Edward Ross Ritvo | Psychiatry & Neurology | 10570 Rocca Way, Los Angeles, CA 90077-2906 | 2007-04-16 |
| 1831217264 | Anandhi Narasimhan | Psychiatry & Neurology | 10850 Wilshire Blvd Ste 200, Los Angeles, CA 90024-4315 | 2007-03-26 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90095 |
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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.