WILSHIRE MULTI-SPECIALTY CLINIC NPI 1487987905

NPI Information

NPI: 1487987905
Provider Name: WILSHIRE MULTI-SPECIALTY CLINIC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
3540 WILSHIRE BLVD
STE: 1028
LOS ANGELES, CA
ZIP 90010
Phone: (213) 388-3712
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WILSHIRE MULTI-SPECIALTY CLINIC is a general practice in Los Angeles, CA. WILSHIRE MULTI-SPECIALTY CLINIC NPI is 1487987905. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3540 WILSHIRE BLVD
STE: 1028
LOS ANGELES, CA
ZIP 90010-307
Phone: (213) 388-3712
Fax: (213) 388-0734

The provider's authorized official is Kusum Rudrappa .
The authorized official title is Medical Director and has the following contact phone number (213) 388-3712.

The enumeration date for this NPI number is 9/16/2009 and was last updated on 9/16/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	152W00000X	Optometrist		G87522	CALIFORNIA	No
2	207QS1201X	Family Medicine	Sleep Medicine			No
3	207RS0010X	Internal Medicine	Sports Medicine	A37070	CALIFORNIA	No
4	207RS0012X	Internal Medicine	Sleep Medicine	A54260	CALIFORNIA	No
5	207Y00000X	Otolaryngology		G36302	CALIFORNIA	No
6	2084P2900X	Psychiatry & Neurology	Pain Medicine	PSY12331	CALIFORNIA	No
7	208D00000X	General Practice		A37070	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	A37070	MEDICARE UPIN	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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