Individual provider Active NPI

Nima Yavari, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1033355904
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A106363 Issued in CA
Practice address
1001 Tiverton Ave
Apt #3129
Los Angeles, CA 90024-3020
Phone
(310) 443-7971
NPI assigned
Dec 26, 2008
Last updated
Jan 23, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A106363 CA Primary

Addresses

Primary practice location

1001 Tiverton Ave
Apt #3129
Los Angeles, CA 90024-3020

Mailing address

1001 Tiverton Ave
Apt #3129
Los Angeles, CA 90024-3020
Phone (310) 443-7971

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090331000210 CA Practitioner - Internal Medicine 9931266236 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
106363CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Minghsun Liu, M.D., PC CurrentSince Dec 4, 2023 Accepting new patients
West Hills Hospital Past Accepting new patients
Rancho Faculty Medical Associates, Inc. Past Accepting new patients
Almighty Hospice Care, Inc. PastSince Jan 26, 2026 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

11103 Venice Blvd
Los Angeles, CA 90034
Phone (310) 734-8526

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1230249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1033355904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 TIVERTON AVE",
            "address_2": "APT #3129",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900243020",
            "telephone_number": "310-443-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 TIVERTON AVE",
            "address_2": "APT #3129",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900243020",
            "telephone_number": "310-443-7971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAVARI",
        "first_name": "NIMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-26",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A106363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.