MEDICARE: DR. JOHN PATRICK WHELAN MD PHD

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	207R00000X	Internal Medicine Physician	A53446	CA
2	208M00000X	Hospitalist Physician	A53446	CA
3	2080P0216X	Pediatric Rheumatology Physician	A53446	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	150043	OTHER	MA	TUFTS HEALTH PLAN
2	J21870	OTHER	MA	BCBS MA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083681258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN PATRICK WHELAN MD PHD

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD STE 400
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5631
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 16TH ST # C2304
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-1249
Country	:	US
Telephone Number	:	310-319-4698
Fax Number	:	310-319-4908

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	11/12/2019

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