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CHARLIE SAM NEPHROLOGY
NPI 1184029712
Clinic/Center - Primary Care in Los Angeles, CA

Active since October 24, 2014CLIA 05D2093541 · Waiver
505 S VIRGIL AVE STE 301, LOS ANGELES, CA 90020(213) 674-8282(213) 232-7013 Get Directions Write a Review

NPPES record last updated: October 24, 2014. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Charlie Sam Nephrology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLIE SAM NEPHROLOGY (NPI 1184029712) is a healthcare organization registered as a primary care in Los Angeles, California and active in the NPI registry since October 2014. The organization holds a CLIA Waiver certificate valid through March 29, 2027 and lists Charles Cho, President, as its authorized official.

NPPES Registry Identity

NPI1184029712
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameCHARLIE SAM NEPHROLOGY
Location Address505 S VIRGIL AVE STE 301Los Angeles, CA 90020-1443
Mailing Address505 S. Virgil Ave., Suite 301Los Angeles, CA 90020 · (213) 674-8282 · Fax (213) 232-7013
Phone(213) 674-8282
Fax(213) 232-7013
Organization SubpartNo
Authorized OfficialCharles ChoPresident · (213) 674-8282
Enumeration DateOctober 24, 2014
✔ NPI 1184029712 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
505 S VIRGIL AVE STE 301, Los Angeles, CA 90020
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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Charlie Sam Nephrology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Charlie Sam Nephrology, which bills Medicare for the services this clinician delivers.

Clinician (1)

Charles Cho, M.D.
Nephrology
NPI 1053512566
505 S VIRGIL AVE STE. 301
Los Angeles, CA 90020
(213) 674-8282
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2093541

Charlie Sam Nephrology · Los Angeles, CA
Active · expires Mar 29, 2027
CLIA Number05D2093541
Laboratory TypePhysician Office
Certificate Effective DateMarch 30, 2025
Certificate Expiration DateMarch 29, 2027
Laboratory DirectorCharles Cho, MD
Laboratory Phone(213) 674-8282
Laboratory LocationCharlie Sam Nephrology505 S Virgil Ave Ste 301, Los Angeles, CA 90020
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charlie Sam Nephrology's NPI number?

The NPI number for Charlie Sam Nephrology is 1184029712. It was assigned to this organization in the NPPES registry on October 24, 2014.

Where is Charlie Sam Nephrology located?

Charlie Sam Nephrology is located at 505 S Virgil Ave Ste 301, Los Angeles, CA 90020. The listed phone number is (213) 674-8282.

What is Charlie Sam Nephrology's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Charlie Sam Nephrology enrolled in Medicare?

Yes. Charlie Sam Nephrology is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Charlie Sam Nephrology?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nephrology) reassigns their Medicare billing to Charlie Sam Nephrology. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Charlie Sam Nephrology hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2093541) is associated with this NPI, valid through March 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Charlie Sam Nephrology was last updated on October 24, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.