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HOLLYWOOD INTERNAL MEDICINE CLINIC INC
NPI 1780449744
Family Medicine in Los Angeles, CA

Active since February 19, 2024
5101 HOLLYWOOD BLVD, LOS ANGELES, CA 90027(323) 426-9139(323) 426-9140 Get Directions Write a Review

NPPES record last updated: March 1, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Hollywood Internal Medicine Clinic Inc NPPES

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

HOLLYWOOD INTERNAL MEDICINE CLINIC INC (NPI 1780449744) is a healthcare organization registered as a family medicine in Los Angeles, California and active in the NPI registry since February 2024. The organization lists Jeffrey Crudo, Ceo/president, as its authorized official.

NPPES Registry Identity

NPI1780449744
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameHOLLYWOOD INTERNAL MEDICINE CLINIC INC
Location Address5101 HOLLYWOOD BLVDLos Angeles, CA 90027-6105
Mailing Address5101 Hollywood BlvdLos Angeles, CA 90027-6105 · (323) 426-9139 · Fax (323) 426-9140
Phone(323) 426-9139
Fax(323) 426-9140
Organization SubpartNo
Authorized OfficialJeffrey CrudoCeo/president · (323) 426-9139
Enumeration DateFebruary 19, 2024
Last NPPES UpdateMarch 1, 2024
NPPES CertifiedMarch 1, 2024
✔ NPI 1780449744 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
5101 HOLLYWOOD BLVD, Los Angeles, CA 90027
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Hollywood Internal Medicine Clinic Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Hollywood Internal Medicine Clinic Inc, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Jeffrey Crudo, M.D.
Internal Medicine
NPI 1508987371
1100 S COAST HWY STE 206
Laguna Beach, CA 92651
(949) 715-6890
✔ PECOS✔ Accepts Medicare48 mi
Dominique Martinez, FNP-BC
Nurse Practitioner
NPI 1225713829
6414 MYRTLE AVE
Glendale, NY 11385
(718) 805-0037
✔ PECOS✔ Accepts Medicare2,459 mi

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

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 Hollywood Internal Medicine Clinic Inc's NPI number?

The NPI number for Hollywood Internal Medicine Clinic Inc is 1780449744. It was assigned to this organization in the NPPES registry on February 19, 2024.

Where is Hollywood Internal Medicine Clinic Inc located?

Hollywood Internal Medicine Clinic Inc is located at 5101 Hollywood Blvd, Los Angeles, CA 90027. The listed phone number is (323) 426-9139.

What is Hollywood Internal Medicine Clinic Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Hollywood Internal Medicine Clinic Inc enrolled in Medicare?

Yes. Hollywood Internal Medicine Clinic Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Hollywood Internal Medicine Clinic Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Hollywood Internal Medicine Clinic Inc, in Internal Medicine and Nurse Practitioner. 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.

When was this NPI record last updated?

The NPPES record for Hollywood Internal Medicine Clinic Inc was last updated on March 1, 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.