Unknown Individual – Allergy & Immunology Physician, NPI 1083721344

Unknown Individual is a healthcare provider. based in Los angeles, California. specializing in Allergy & Immunology Physician. They hold a License No. C29028 (CA). The NPI Number for Unknown Individual is 1083721344

Main info

Organization
Inactive
61 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1083721344
Phone
(310) 393-1550
Address
11500 W OLYMPIC BLVD
Deactivation Date
8 February 2023

Doctor Profile

Medical School Name
UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
Secondary Phone
3103931550
Graduation Year
1965 (61 years ago)
PAC ID
5193613941
Group Practice PAC ID
1658470133
Professional Enrollment ID
I20040304001121
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • West Olympic Boulevard, Mid-Wilshire, Los Angeles, Los Angeles County, California, 90064, United States

    SUITE 630

    LOS ANGELES, CA 900641524

    Phone: (310) 393-1550

    Fax: (310) 478-3601

    Type: Mailing

  • 630, West Olympic Boulevard, South Park, Downtown, Los Angeles, Los Angeles County, California, 90015, United States

    LOS ANGELES, CA 900641538

    Phone: (310) 393-1550

    Fax: (310) 478-3601

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $14.

Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.

Last reported payment date: 2023-03-30 • Largest payer in this snapshot: PFIZER INC. ($14).

Total Amount

$14

General + Research + Ownership

Payments

1

Total payment records

General Amount

$14

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-03-30

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
PFIZER INC.$14
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 90064)

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Provider's Procedures

Unknown Individual performs procedures in Allergy & Immunology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ALLERGY/IMMUNOLOGYCA92567Eardrum testing using ear probe10356
ALLERGY/IMMUNOLOGYCA94060Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration5439

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1658470133View full group profile
NameSpecialtyState
Internal MedicineCA
A L L E R G Y/ I M M U N O L O G YCA
A L L E R G Y/ I M M U N O L O G YCA
A L L E R G Y/ I M M U N O L O G YCA

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1083721344 when you need to reference Unknown Individual in forms, claims, or directories.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Allergy & Immunology Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in California?
You will see Los Angeles, California on file for Unknown Individual alongside any extra practice locations.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1083721344. Always confirm identity and privileges with the practice and licensing boards.

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