1174375513 NPI number — MR. JAMES KELLY TAPPARO II

Table of content: MR. JAMES KELLY TAPPARO II (NPI 1174375513)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174375513 NPI number — MR. JAMES KELLY TAPPARO II

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TAPPARO
Provider First Name:
JAMES
Provider Middle Name:
KELLY
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
II
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174375513
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/04/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1007 MYRTLE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INGLEWOOD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90301-4009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-412-4191
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
DIDI HIRSCH PSYCHIATRIC SERVICES
Provider Second Line Business Practice Location Address:
4760 SEPULVEDA BLVD
Provider Business Practice Location Address City Name:
CULVER CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90230-4820
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-390-6612
Provider Business Practice Location Address Fax Number:
310-398-5690
Provider Enumeration Date:
04/01/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 373H00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)