MEDICARE: LOS ANGELES DEVELOPMENTAL BEHAVIORAL PEDIATRIC MEDICAL GROUP, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0006X	Developmental - Behavioral Pediatrics Physician

General Provider Information

NPI Number	:	1912836420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOS ANGELES DEVELOPMENTAL BEHAVIORAL PEDIATRIC MEDICAL GROUP, P.C.

Provider Business Mailing Address
First Line	:	PO BOX 6098
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91510-6098
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5955 LANKERSHIM BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-1006
Country	:	US
Telephone Number	:	818-445-8037
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	SAIRAM KUMAR
Credential	:
Telephone Number	:	818-445-8037

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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