Unknown Individual – Internal Medicine Physician, NPI 1114923570

Unknown Individual is a healthcare provider. based in Los angeles, California. specializing in Internal Medicine Physician. They hold a License No. G40739 (CA). The NPI Number for Unknown Individual is 1114923570

Main info

Organization
Inactive
38 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1114923570
Phone
(310) 423-6325
Address
8700 BEVERLY BLVD
Deactivation Date
14 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3104235000
Graduation Year
1988 (38 years ago)
PAC ID
8729986575
Group Practice PAC ID
0446169114
Professional Enrollment ID
I20101104001507
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Cedars-Sinai Medical Center, 8700, Beverly Boulevard, West Hollywood, Los Angeles County, California, 90048, United States

    LOS ANGELES, CA 900481804

    Phone: (310) 423-6325

    Fax: (310) 423-0436

    Type: Location

  • Box, Lago del Salado, Los Angeles, San Nicolás de los Garza, Nuevo León, 66477, Mexico

    LOS ANGELES, CA 900510717

    Phone: (310) 967-1884

    Fax: (310) 967-1774

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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 90048)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINECA76942Ultrasonic guidance imaging supervision and interpretation for insertion of needle280227

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: 0446169114View full group profile
NameSpecialtyState
Critical Care (Intensivists), General SurgeryCA
-WA
Nurse PractitionerCA
Physician AssistantCA
Clinical PsychologistCA
Nurse PractitionerCA
Nurse PractitionerCA
General Surgery, Critical Care (Intensivists)CA
Internal MedicineCA
Plastic And Reconstructive SurgeryCA

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1114923570 if you need a stable reference for Unknown Individual.
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.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Internal Medicine 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 this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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