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LOGAN GUNDERSON MD
NPI 1548025703
Student in an Organized Health Care Education/Training Program in Los Angeles, CA

Active since February 16, 2024PECOS Enrolled
885 TIVERTON DRIVE, LOS ANGELES, CA 90095(310) 825-6373 Get Directions Write a Review

NPPES record last updated: February 29, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Logan Gunderson Md NPPES

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

LOGAN GUNDERSON MD (NPI 1548025703) is an individual student in an organized health care education/training program in Los Angeles, California and active in the NPI registry since February 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1548025703
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameLOGAN GUNDERSONCredential: MD
Location Address885 TIVERTON DRIVELos Angeles, CA 90095-0001
Mailing Address885 Tiverton DriveLos Angeles, CA 90095-0001 · (310) 825-6373
Phone(310) 825-6373
Sole ProprietorYes
Enumeration DateFebruary 16, 2024
Last NPPES UpdateFebruary 29, 2024
NPPES CertifiedFebruary 29, 2024
✔ NPI 1548025703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
885 TIVERTON DRIVE, 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)

Logan Gunderson Md 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 20

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

ISAURA FROST LINS PHD
Student in an Organized Health Care Education/Training Program
885 TIVERTON DRIVE
LOS ANGELES, CA 90095
Los Angeles County (310) 825-6373
ESMERALDA RUIZ
Student in an Organized Health Care Education/Training Program
885 TIVERTON DRIVE
LOS ANGELES, CA 90095
Los Angeles County (310) 825-6373
KUSHAGRA TEWARI MD
Student in an Organized Health Care Education/Training Program
885 TIVERTON DRIVE
LOS ANGELES, CA 90095
Los Angeles County (310) 825-6373
ZOE REBECCA FORD ADELSHEIM
Student in an Organized Health Care Education/Training Program
885 TIVERTON DRIVE
LOS ANGELES, CA 90095
Los Angeles County (310) 825-6373
RUJUTA SAMIR SATHE
Student in an Organized Health Care Education/Training Program
885 TIVERTON DRIVE
LOS ANGELES, CA 90095
Los Angeles County (408) 594-5925
TANYA DATTA
Student in an Organized Health Care Education/Training Program
885 TIVERTON DRIVE
LOS ANGELES, CA 90095
Los Angeles County (310) 825-6373
YADIRA LIZBETH BRIBIESCA LEON MD
Student in an Organized Health Care Education/Training Program
885 TIVERTON DRIVE
LOS ANGELES, CA 90095
Los Angeles County (310) 825-6373
EMMA CLAIRE BILLINGS
Student in an Organized Health Care Education/Training Program
885 TIVERTON DRIVE
LOS ANGELES, CA 90095
Los Angeles County (310) 825-6373

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 Logan Gunderson's NPI number?

The NPI number for Logan Gunderson is 1548025703. It was assigned to this individual provider in the NPPES registry on February 16, 2024.

Where is Logan Gunderson located?

Logan Gunderson practices at 885 Tiverton Drive, Los Angeles, CA 90095. The listed phone number is (310) 825-6373.

What is Logan Gunderson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Logan Gunderson enrolled in Medicare?

Yes. Logan Gunderson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Logan Gunderson was last updated on February 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.