NPIMap

Individual provider Active NPI

Alfred Rahban, M.D.A MEDICAL CORPOR

  • Nephrology Physician
  • Los Angeles, CA
National Provider Identifier
1003924168
Registry record updated Feb 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A51095 Issued in CA
Practice address
5901 W Olympic Blvd
Suite 307
Los Angeles, CA 90036-4667
Phone
(323) 939-3669
Fax
(323) 798-1786
NPI assigned
Aug 29, 2006
Last updated
Feb 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A51095 CA Primary

Addresses

Primary practice location

5901 W Olympic Blvd
Suite 307
Los Angeles, CA 90036-4667

Mailing address

5901 W Olympic Blvd
Suite 307
Los Angeles, CA 90036-4667
Phone (323) 939-3669

Other identifiers 1

IdentifierTypeStateIssuer
1003924168MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080229000401 CA Practitioner - NephrologyPractitioner - Internal Medicine 1052495967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8631 W 3Rd St
Los Angeles, CA 90048-5901
Phone (323) 939-3669

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A51095CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alfred Rahban a Medical Corporation Nephrology CurrentSince Feb 29, 2008 Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients

Locations

5901 W Olympic Blvd
Ste 307
Los Angeles, CA 90036
Phone (310) 642-7774

8631 W 3rd St
Ste 1030E
Los Angeles, CA 90048
Phone (310) 652-8446

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kennedy Care CenterLos Angeles, CA, CCN 055977 Skilled nursing facility Contracted Managing Employee Jan 1, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1003924168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 W OLYMPIC BLVD",
            "address_2": "SUITE 307",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364667",
            "telephone_number": "323-939-3669",
            "fax_number": "323-798-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 W OLYMPIC BLVD",
            "address_2": "SUITE 307",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364667",
            "telephone_number": "323-939-3669",
            "fax_number": "323-798-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHBAN",
        "first_name": "ALFRED",
        "credential": "M.D.A MEDICAL CORPOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A51095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003924168",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.