Dr. Keith Gregory Heinzerling
Internal Medicine (Addiction Medicine)

Address: 1920 Colorado Ave, Santa Monica, CA 90404-3414
Phone: 3103194700

Dr. Keith Gregory Heinzerling (NPI# 1184724932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1184724932
Entity Type Individual
Full Name Dr. Keith Gregory Heinzerling
Credential MD
Gender Male
Practice Address 1920 Colorado Ave
Santa Monica
CA 90404-3414
Practice Telephone 3103194700
Practice Fax Number 3103935659
Mailing Address 1920 Colorado Ave
Santa Monica
CA 90404-3414
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-09-22
Last Update Date 2012-01-13

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
No 207R00000X Internal Medicine Allopathic & Osteopathic Physicians A79201 CA
Yes 207RA0401X Internal Medicine · Addiction Medicine Allopathic & Osteopathic Physicians A79201 CA

Physician Overview

NPI 1184724932
PAC ID by PECOS 7618904038
Professional Enrollment ID I20050718000694
Full Name Keith G Heinzerling
Organization Legal Name UC REGENTS UCLA FAMILY HEALTH CENTER
Phone Number 3103194700
Gender M
Credential MD
Medical School STANFORD UNIVERSITY SCHOOL OF MEDICINE
Graduation Year 1998
Primary Specialty INTERNAL MEDICINE
Group Practice PAC ID 9739083866
Number of Group Practice Members 34
Accepts Medicare Assignment Y
Report Quality Measures Y
Use Electronic Health Records Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
050112 SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL

Office Location

Street Address 1920 COLORADO AVE
City SANTA MONICA
State CA
Zip Code 90404-3414

Providers in the same location

NPI Name Taxonomy Address Enumeration
1275591802 Uc Regents Ucla Family Health Center Family Medicine 1920 Colorado Ave, Santa Monica, CA 90404-3414 2006-05-03
1245792712 Ann Marie Hernandez Student in an Organized Health Care Education/Training Program 1920 Colorado Ave, Santa Monica, CA 90404-3414 2019-04-03
1033670138 Olivia Taeko Ishibashi Student in an Organized Health Care Education/Training Program 1920 Colorado Ave, Santa Monica, CA 90404-3414 2019-03-29
1194286047 Colleen O'neil-tennant Student in an Organized Health Care Education/Training Program 1920 Colorado Ave, Santa Monica, CA 90404-3414 2019-03-25
1104386069 Spencer Mccaffrey Student in an Organized Health Care Education/Training Program 1920 Colorado Ave, Santa Monica, CA 90404-3414 2019-03-25
1437618469 Jolie Portanova Cooperman Student in an Organized Health Care Education/Training Program 1920 Colorado Ave, Santa Monica, CA 90404-3414 2019-03-19
1649739764 Nelson Boland Student in an Organized Health Care Education/Training Program 1920 Colorado Ave, Santa Monica, CA 90404-3414 2019-03-18
1093212334 Amy M Richards Student in an Organized Health Care Education/Training Program 1920 Colorado Ave, Santa Monica, CA 90404-3414 2018-04-12
1922505494 Angela Patricia Sepulveda Velez Student in an Organized Health Care Education/Training Program 1920 Colorado Ave, Santa Monica, CA 90404-3414 2018-04-10
1578060588 Jennifer Kho Ting Casabar Student in an Organized Health Care Education/Training Program 1920 Colorado Ave, Santa Monica, CA 90404-3414 2018-04-07
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1841763687 Crystal Monique Mckinley X Counselor 1865 9th St, Santa Monica, CA 90404 2019-01-04
1952872749 Cesar O Munoz Counselor 1865 9th St., Santa Monica, CA 90404 2018-12-06
1023596574 Joseph J Pinzone Md Inc Internal Medicine 2001 Santa Monica Blvd Ste 1190, Santa Monica, CA 90404 2018-08-06
1548763535 Alan Rubenstein Dds Inc Dentist 1260 15th St., #703, Santa Monica, CA 90404 2018-03-15
1669993382 Aaron Wilson Counselor 1453 16th Street, Santa Monica, CA 90404 2017-07-03
1922472471 Chianni Lin Acupuncturist 2222 Santa Monica Blvd, Ste. 105, Santa Monica, CA 90404 2015-11-20
1467823278 Alexandra Daniela Arroyo Behavior Analyst 1838 22nd St Apt 2, Santa Monica, CA 90404 2015-10-20
1720498504 Alan Jeff Baldrias Nurse Practitioner 3300 East South St. # 203, Long Beach, CA 90404 2014-05-02
1598185647 Matthew Mcadams Rehabilitation Practitioner 1453 16th St., Santa Monica, CA 90404 2014-04-16
1720410061 Jennafer Diane Piccolo Francis Physician Assistant 9915 S. Santa Monica Blvd, Beverly Hills, CA 90404 2013-08-08
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Taxonomy Information

Taxonomy Code 207RA0401X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Addiction Medicine

Taxonomy Definition

An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: http://www.osteopathic.org/certification

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1578987251 Westcoast Medical Group, Inc. Internal Medicine 171 Pier Ave #112, Santa Monica, CA 90405-5363 2014-02-14
1811446768 David A Sack Md A Professional Medical Corporation Internal Medicine 2515 Wilshire Blvd, Santa Monica, CA 90403-4615 2016-10-03

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1356817886 Bicycle Health Provider Group Inc. Internal Medicine 1952 15th St, San Francisco, CA 94114-1728 2018-10-23
1245767516 Chemical Dependency Treatment Associates, Inc Internal Medicine 455 University Ave Ste 320, Sacramento, CA 95825-6580 2017-05-17
1568917367 Mjc Hospitalist Group, Inc. Internal Medicine 4615 Lemona Ave, Sherman Oaks, CA 91403-2428 2016-08-22
1073962171 Faried Banimahd Md Inc Internal Medicine 23961 Calle De La Magdalena Ste 424, Laguna Hills, CA 92653-3685 2016-06-09
1467827683 360 Recovery Inc Internal Medicine 23986 Aliso Creek Rd Ste 226, Laguna Niguel, CA 92677-3908 2015-12-14
1841665254 Kpg California, LLC Internal Medicine 9000 W Sunset Blvd Ste 1500, West Hollywood, CA 90069-5815 2015-12-10
1730561861 Synergy Lifestyle Center, Inc. Internal Medicine 7910 Downing Ave Ste 200, Bakersfield, CA 93308-5016 2015-06-25
1265810311 Products for Recovery Management Group, LLC Internal Medicine 24482 Caracas St., Dana Point, CA 92629-4167 2015-05-09
1033452727 Joseph Abraham Mott Internal Medicine 2095 N Indian Canyon Dr, Palm Springs, CA 92262-3019 2013-04-01
1134474042 Richard C. Scatterday Internal Medicine 629 S Greenwich St, Anaheim, CA 92804-3438 2012-07-17
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Competitor

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City SANTA MONICA
Zip Code 90404

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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