Unknown Individual – Gastroenterology Physician, NPI 1306832399

Unknown Individual is a healthcare provider. based in Los angeles, California. specializing in Gastroenterology Physician. They hold a License No. G53608 (CA). The NPI Number for Unknown Individual is 1306832399

Main info

Organization
Inactive
43 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1306832399
Phone
(213) 480-0711
Address
1245 WILSHIRE BLVD STE 780
Deactivation Date
24 March 2021

Doctor Profile

Medical School Name
UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Secondary Phone
2134800711
Graduation Year
1983 (43 years ago)
PAC ID
1355445982
Group Practice PAC ID
8527162155
Professional Enrollment ID
I20070409000321
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

Provider Addresses for Unknown Individual

  • 1245 WILSHIRE BLVD STE 780

    LOS ANGELES, CA 900174881

    Phone: (213) 480-0711

    Fax: (213) 480-0715

    Type: Location

  • 3188, West Olympic Boulevard, Koreatown, Los Angeles, Los Angeles County, California, 90006, United States

    SUITE 103

    LOS ANGELES, CA 900062421

    Phone: (213) 480-0711

    Fax: (213) 480-0715

    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.

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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 90017)

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Provider's Procedures

Unknown Individual performs procedures in Gastroenterology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
GASTROENTEROLOGYCA43235Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope4846
GASTROENTEROLOGYCA45378Diagnostic examination of large bowel using an endoscope4442
GASTROENTEROLOGYCA45385Removal of polyps or growths of large bowel using an endoscope6260

Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1306832399.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Gastroenterology Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Los Angeles, California in the same public data insurers reference.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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