NPI |
1083973192 |
The last name of the provider. If the provider is an individual, this is the legal name. |
Entity Type Code |
1 |
The first name of the provider, if the provider
is an individual. |
Provider Last Name Legal Name |
METH |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Provider First Name |
SYDNEY |
The city name in the location address of the provider being identified. |
Provider First Line Business Practice Location Address |
605 W OLYMPIC BLVD STE 600 |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address City Name |
LOS ANGELES |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Business Practice Location Address State Name |
CA |
The country code in the location address of the provider being identified. |
Provider Business Practice Location Address Postal Code |
900151475 |
The telephone number associated with the location address of the provider being identified. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The date the provider was assigned a unique identifier (assigned an NPI). |
Provider Business Practice Location Address Telephone Number |
2135531884 |
The date that a record was last updated or changed. |
Provider Business Practice Location Address Fax Number |
2132369662 |
The code designating the provider’s gender if the provider is a person. |
Provider Enumeration Date |
5/9/2012 |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Last Update Date |
5/9/2012 |
The license number issued to the provider being identified. The NPS can accommodate
multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’. |
Provider Gender Code |
F |
The code designating the provider’s gender if the provider is a person. |
Healthcare Provider Taxonomy Code 1 |
171M00000X |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Is Sole Proprietor |
Y |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |