ANDREW KASSINOVE, MD; INC. , NPI 1023059524 — LOS ANGELES (CA)

NPI 1023059524

13+ Years Experience Organization

ANDREW KASSINOVE, MD; INC.

06.08.2006
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1023059524
NPI NUMBER

About ANDREW KASSINOVE, MD; INC.

ANDREW KASSINOVE, MD; INC. is a provider established in LOS ANGELES, CA. The NPI number of ANDREW KASSINOVE, MD; INC. is 1023059524 and was assigned on 06.08.2006. The practitioners primary taxonomy code is: 207P00000X .

Mailing address

  • City: RANCHO PALOS VERDES
  • State: CA
  • Postal code: 902756243
  • Phone: 3109511714
  • Address: 30925 GANADO DR
  • Address 2: RANCHO PALOS

Primary Practice Address

  • Region : LOS ANGELES, CA
  • NPI : 1023059524
  • Phone : 2134847301
  • Postalcode : 900571901
  • Address : 2131 W 3RD ST

Additional identifiers

  • Identifier: DD6313
  • Code / Type : 1 - other
  • Identifier state : CA
  • Identifier issuer: RAILROAD MEDICARE

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Provider taxonomy - Emergency Medicine

  • Taxonomy code: 207P00000X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy group: 193200000X MULTI-SPECIALTY GROUP.

Taxonomy description: An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Contacts:

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  • ANDREW KASSINOVE, MD; INC.
  • Address : 2131 W 3RD ST
  • Region : LOS ANGELES, CA
  • NPI : 1023059524
  • Phone : 2134847301
  • Postalcode : 900571901

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 3109511714
  • Title or position : PRESIDENT
  • Credentials : MD

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address2131 W 3RD ST
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 Business Practice Location Address City NameLOS ANGELES
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameCA
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code900571901
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 Telephone Number2134847301
The telephone number associated with the location address of the provider being identified.
NPI1023059524
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1207P00000X
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Provider Enumeration Date06.08.2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)ANDREW KASSINOVE, MD; INC.
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address30925 GANADO DR
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressRANCHO PALOS
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameRANCHO PALOS VERDES
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameCA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code902756243
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number3109511714
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Authorized Official Last NameKASSINOVE
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameANDREW
The first name of the authorized official
Authorized Official Title or PositionPRESIDENT
The title or position of the authorized official
Authorized Official Name Prefix TextDR.
Authorized Official Name Prefix Text
Authorized Official Credential TextMD
Authorized Official Credential Text
Authorized Official Telephone Number3109511714
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1207P00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Emergency Medicine
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 1DD6313
Other Provider Identifier #1
Other Provider Identifier Type 11
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1CA
Other Provider Identifier State #1
Other Provider Identifier Issuer 1RAILROAD MEDICARE
Other Provider Identifier Issuer #1
X

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