PRAVEEN REDDY KAMBAM (NPI# 1912034141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912034141 |
| Entity Type | Individual |
| Full Name | PRAVEEN REDDY KAMBAM |
| Credential | M.D. |
| Practice Address |
11500 W Olympic Blvd 538 Los Angeles CA 90064 |
| Mailing Address |
11500 W Olympic Blvd Ste 538 Los Angeles CA 90064-1672 |
| Practice Telephone | 3102318964 |
| Practice Fax Number | 3106271657 |
| Mailing Telephone | 3102318964 |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2019-02-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
A100457 | CA | Allopathic & Osteopathic Physicians |
| Y | 2084F0202X |
Psychiatry & Neurology Specialization: Forensic Psychiatry |
A100457 | CA | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
A100457 | CA | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
A100457 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
11500 W OLYMPIC BLVD 538 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306827324 | Christine Choi Kim | Dermatology | 11500 W Olympic Blvd, Suite 480, Los Angeles, CA 90064-1524 | 2005-11-08 |
| 1851822845 | Erin Amini | Marriage & Family Therapist | 11500 W Olympic Blvd, Suite 538, Los Angeles, CA 90064-1524 | 2017-03-22 |
| 1780126763 | Michele Robin Hahn | Marriage & Family Therapist | 11500 W Olympic Blvd, Suite 578, Los Angeles, CA 90064-1524 | 2016-11-08 |
| 1215389556 | Perspective Psychotherapy and Counseling Services LLC | Counselor | 11500 W Olympic Blvd, Ste 617, Los Angeles, CA 90064-1524 | 2016-07-11 |
| 1154785186 | Steven Wayne Lee | Marriage & Family Therapist | 11500 W Olympic Blvd, Suite 617, Los Angeles, CA 90064-1524 | 2016-04-06 |
| 1578920104 | William F Stubbeman Md A Professional Corporation | Psychiatry & Neurology | 11500 W Olympic Blvd, Suite 441, Los Angeles, CA 90064-1524 | 2016-01-27 |
| 1366809618 | Jared Cato | Physical Therapist | 11500 W Olympic Blvd, 640, Los Angeles, CA 90064-1524 | 2016-01-18 |
| 1801261748 | Kelly Masuda | Physical Therapist | 11500 W Olympic Blvd, Ste 350, Los Angeles, CA 90064-1524 | 2015-12-03 |
| 1124492269 | Shayna Reid | Physical Therapist | 11500 W Olympic Blvd, Suite 440, Los Angeles, CA 90064-1524 | 2015-11-29 |
| 1275906695 | Erica M Sanborn | Psychologist | 11500 W Olympic Blvd, Los Angeles, CA 90064-1524 | 2015-11-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134727597 | Barbara K. Polland | Marriage & Family Therapist | 10533 Rountree Rd., Los Angeles, CA 90064 | 2020-10-16 |
| 1912542994 | Reproductive Medicine Associates of Socal Ambulatory Surgery Center | Clinic/Center | 11500 W Olympic Blvd, Ste# 150, Los Angeles, CA 90064 | 2019-11-13 |
| 1376022012 | Payersdirect, Inc. | Radiology | 11845 W Olympic Blvd Ste 1100w, Los Angeles, CA 90064 | 2018-08-13 |
| 1013404136 | Jeannie Wakamatsu | Dietitian, Registered | 10312 Almayo Ave., Suite 6, Los Angeles, CA 90064 | 2018-04-13 |
| 1487153474 | Victor Louie | Behavior Technician | 11835 W Olympic Blvd Suite 140e, Los Angeles, CA 90064 | 2018-02-06 |
| 1538683842 | Ana Grinfeld | Behavioral Analyst | 11835 W Olympic Blvd Ste 140e, Los Angeles, CA 90064 | 2017-07-28 |
| 1407386089 | Ovsanna Stepanyan | Rehabilitation Practitioner | 11080 W Olimpic Blvd, La, CA 90064 | 2017-06-15 |
| 1952768012 | Grace Gayles | Behavioral Analyst | 11835 W. Olympic Blvd., Suite 140e, Los Angeles, CA 90064 | 2016-01-20 |
| 1669841003 | Jessica Hildebrandt | Occupational Therapy Assistant | 2446 S Westgate Ave, Los Angeles, CA 90064 | 2015-09-16 |
| 1033592571 | Joshua Busse | Family Medicine | 11845 Olympic Boulevard, Los Angeles, CA 90064 | 2015-07-01 |
| Find all providers in zip 90064 | ||||
| Taxonomy Code | 2084F0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Forensic Psychiatry |
| Forensic Psychiatry is a subspecialty with psychiatric focus on interrelationships with civil, criminal and administrative law, evaluation and specialized treatment of individuals involved with the legal system, incarcerated in jails, prisons, and forensic psychiatry hospitals. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013237064 | Artha Gillis | Psychiatry & Neurology | 760 Westwood Plz Rm C8-193, Los Angeles, CA 90024-5055 | 2010-06-01 |
| 1942538343 | Alex Sahba Md, A Medical Corp | Psychiatry & Neurology | 2355 Westwood Blvd # 129, Los Angeles, CA 90064-2109 | 2009-11-23 |
| 1194987339 | Mark Steven Lipian | Psychiatry & Neurology | 2029 Century Park East, Suite 2890, Los Angeles, CA 90067-2901 | 2008-06-30 |
| 1407911662 | Samuel I Miles | Psychiatry & Neurology | 8631 W 3rd St Ste 425e, Los Angeles, CA 90048-5908 | 2006-12-27 |
| 1982774147 | Michael Malkin | Psychiatry & Neurology | 120 N Vista St, Los Angeles, CA 90036-2710 | 2006-11-08 |
| 1568488963 | Paul Bradley Bohn | Psychiatry & Neurology | 12300 Wilshire Blvd Ste 330, Los Angeles, CA 90025-1057 | 2006-07-15 |
| 1063418788 | John Ira Hochman | Psychiatry & Neurology | 6333 Wilshire Blvd, Ste 402, Los Angeles, CA 90048-5702 | 2005-06-27 |
| 1124472212 | Michael Kanell | Psychiatry & Neurology | 760 Westwood Plz Ste 37-384, Los Angeles, CA 90024-5055 | 2016-04-15 |
| 1124446224 | Thomas Rodriguez | Psychiatry & Neurology | 1200 N State St, Los Angeles, CA 90033-1029 | 2014-04-04 |
| 1669740338 | Jack Rothberg Md A Medical Copt | Psychiatry & Neurology | 6200 Wilshire Blvd, Suite 1612, Los Angeles, CA 90048 | 2011-12-08 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90064 |
Please comment or provide details below to improve the information on PRAVEEN REDDY KAMBAM.
| 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.