IRENE KOOLWIJK M.D.
NPI 1518164706
Pediatrics - Developmental - Behavioral Pediatrics in Los Angeles, CA

Q: What is Irene Koolwijk's NPI number?

The NPI number for Irene Koolwijk is 1518164706. It was assigned to this individual provider in the NPPES registry on June 29, 2007.

Q: What is Irene Koolwijk's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Developmental - Behavioral Pediatrics, with taxonomy code 2080P0006X.

Q: When was this NPI record last updated?

The NPPES record for Irene Koolwijk was last updated on April 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since June 29, 2007PECOS Enrolled

300 UCLA MEDICAL PLZ STE 3300, LOS ANGELES, CA 90095(310) 825-0867(310) 206-4855 Get Directions Write a Review

NPPES record last updated: April 26, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 26, 2021, Apr 19, 2021, Feb 17, 2021 (3 updates tracked since 2021).

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About Irene Koolwijk M.d. NPPES

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

IRENE KOOLWIJK M.D. (NPI 1518164706) is an individual developmental - behavioral pediatrics provider in Los Angeles, California, licensed in California (A121627) and active in the NPI registry since June 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1518164706

Entity TypeIndividualFemale

Primary Taxonomy2080P0006X

Provider Legal NameIRENE KOOLWIJKCredential: M.D.

Location Address300 UCLA MEDICAL PLZ STE 3300Los Angeles, CA 90095-6062

Mailing Address5767 W Century Blvd Ste 400Los Angeles, CA 90045-5631 · (310) 301-8707 · Fax (310) 301-8751

Phone(310) 825-0867

Fax(310) 206-4855

Sole ProprietorNo

Enumeration DateJune 29, 2007

Last NPPES UpdateApril 26, 20213 updates tracked since enumeration

NPPES CertifiedApril 26, 2021

✔ NPI 1518164706 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatrics · Developmental - Behavioral PediatricsAllopathic & Osteopathic Physicians

Taxonomy Code2080P0006X

License✔ Licensed in CA · A121627

Definition

A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.

Also ListedPediatricsTaxonomy 208000000X · License A121627 (CA)

Also ListedPediatrics · Neurodevelopmental DisabilitiesTaxonomy 2080P0008X · License A121627 (CA)

300 UCLA MEDICAL PLZ STE 3300, Los Angeles, CA 90095

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Irene Koolwijk M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KELSEY STILES PHD

Psychologist (Clinical)